Stable micelles of fatty acid esters

ABSTRACT

Described herein are compositions comprising at least one Omega-3 fatty acid ester and at least one surface active agent; wherein the compositions form micelles when in contact with an aqueous medium. Also provided is a method of administering to a subject a composition comprising at least one Omega-3 fatty acid ester and at least one surface active agent, wherein the at least one Omega-3 fatty acid ester forms micelles when in contact with an aqueous medium, and the bioavailability of the at least one Omega-3 fatty acid ester is substantially independent of a food effect. Said compositions are useful for treating cardiovascular conditions or disorders in a subject and for reducing side effects associated with the ingestion of Omega-3 fatty acid esters. Described are also various dosage forms for administering said compositions and use of said compositions in functional foods. Provided herein are also kits with instructions on how to administer said compositions.

CROSS REFERENCE TO RELATED APPLICATIONS

This patent application is a continuation of U.S. patent applicationSer. No. 14/456,750, filed Aug. 11, 2014, which is a continuation of andclaims priority to PCT International Patent Application No.PCT/US13/30211 entitled Omega-3 Fatty Acid Ester Compositions filed onMar. 11, 2013 and which is related and claims priority to U.S.Provisional Patent Application No. 61/618,161 filed Mar. 30, 2012; theentire disclosures of which are specifically incorporated by referenceherein in their entirety.

BACKGROUND

According to the World Health Organization's (WHO) fact sheet onCardiovascular Diseases (CVDs), CVDs are the number one cause of deathglobally. (Fact Sheet No. 317, September 2012 accessed at(http://www.who.int/mediacentre/factsheets/fs317/en/index.html on Jan.31, 2013). The WHO estimates that an estimated 17.3 million people diedfrom CVDs in 2008, representing 30% of all global deaths. Of thesedeaths, an estimated 7.3 million were due to coronary heart disease(CHD) and 6.2 million were due to stroke. The WHO also estimates that by2030, almost 25 million people will die from CVDs, mainly from heartdisease and stroke. The Global Burden of Disease Study estimates thatthe developing countries contributed 3.5 million of the 6.2 millionglobal deaths from CHD in 1990. (Murray C J L and Lopez A D. The GlobalBurden of Disease A Comprehensive Assessment of Mortality and Disabilityfrom Disease, Injuries and Risk Factors in 1990 and Projected to 2020.Boston, Ma Harvard University Press; 1996). The projections estimatethat these countries will account for 7.8 million of the 11.1 milliondeaths due to CHD in 2020. The developed countries are not immune toCHD. For example, in the USA and Europe, CHD remains the largest singlecause of death and disability. In 2005, CHD caused approximately 1 ofevery 5 deaths in the USA. (Heron M P, et. al. Deaths preliminary datafor 2006. Natl. Vital. Stat. Rep. 2008; 56:1-52.) According to theCenters for Disease Control and Prevention it is the leading cause ofdeath in America. Approximately 37% of people who develop a coronaryevent in a given year will die from it. While major reductions in CVDrelated mortality have been achieved in Europe, CVD still accounts for54% of all deaths in women and 43% of all deaths in men.

CVD is associated with many risk factors. Of these risk factors,hyperlipidemia (e.g., hypertriglyceridemia) and hypercholesterolemia aresignificant indicators of CVD. As such, dietary supplements,nutraceuticals, and prescribed drugs containing Omega-3 fatty acidesters, such as the ethyl esters of EPA and DHA, are currently used forthe treatment of CVD and, in particular, for the reduction of elevatedtriglycerides.

However, administration of dietary supplements, nutraceuticals, andprescribed drugs containing Omega-3 fatty acid esters presentssignificant challenges. For example, current dietary supplements,nutraceuticals, and prescribed drugs containing Omega-3 fatty acidesters have variable absorption and efficacy when orally administered.In particular, current compositions have a pronounced “food effect,”with poor absorption when taken while fasting or with a low fat meal.When taken with fatty foods, the absorption of Omega-3 fatty acid estersimproves, due in part to the presence of bile salts that are released inthe intestines, which aid absorption of Omega-3 fatty acid esters.

To overcome low absorption, patients can be dosed with compositionshaving greater amounts of Omega-3 fatty acid esters, but there arepractical limitations to this approach due to the side effects that arecommonly associated with such compositions. The oxidative degradation ofOmega-3 fatty acid esters that occurs over time can result in anunpleasant aftertaste following administration, especially when consumedin large quantities. Burping and stomach upset are further unpleasantside effects associated with the consumption of Omega-3 fatty acidesters. Following consumption, Omega-3 fatty acid esters tend to floaton top of liquid contents in the stomach, forming a layer that preventsthe passage of small gas bubbles. When sufficient gas has built up toovercome the surface tension of the oil layer, a person burps. The burpsusually contain a fishy taste and smell.

Accordingly, side effects associated with the administration of currentcompositions comprising Omega-3 fatty acid esters (e.g., susceptibilityto the food effect, large doses to attain efficacy, and the resultingaftertaste, unpleasant smell, and burping) are known to significantlyreduce patient compliance.

While practicing a healthy lifestyle may reduce the incidence of CVD,new therapeutic approaches to manage CVD are warranted. These newapproaches might include the discovery of new drugs or improve uponcurrent medications used to treat CVD. The discovery of new drugs,however, comes at a high price with no certainty of eventual success.Accordingly, new or more efficient ways of delivering currentmedications with a proven safety and efficacy profile should bedeveloped. Thus, there is a need for improved compositions comprisingOmega-3 fatty acid esters, such as the ethyl esters of EPA and DHA, thatare less susceptible to food effect and which attain high efficacy atlower doses. Ideally, such improved compositions would minimize oreliminate an unpleasant smell and/or an unpleasant aftertaste, and/orburping in the patient. Such an improved composition with reduced sideeffects would improve patient compliance and more effectively treat therisk factors related to cardiovascular disease.

SUMMARY

In all of the embodiments provided herein, all of the compositions arefree of Omega-3 free fatty acids. Provided herein, in certainembodiments, are compositions comprising EPA and DHA esters incombination with at least one surface active agent. In certainembodiments, the ratio of EPA ester to DHA ester is from more than 2:1to not more than 3.4:1. Certain embodiments provide for the ratio of theEPA ester to the DHA ester to be from about 2:1 to about 3.4:1. Providedherein, in certain embodiments, are compositions comprising at least oneOmega-3 fatty acid ester and at least one surface active agent. Incertain embodiments, the Omega-3 fatty acid ester is selected from thegroup consisting of hexadecatrienoic acid, α-linolenic acid, stearidonicacid, eicosatrienoic acid, eicosapentaenoic acid, heneicosapentaenoicacid, docosapentenoic acid, docosahexaenoic acid, tetracosapentenoicacid, tetracosahexaenoic acid, or combinations thereof. Certainembodiments provide for compositions comprising the ethyl esterderivative of said Omega-3 fatty acid ester, optionally in combinationwith at least one surface active agent, at least one terpene, at leastone antioxidant, or combinations thereof. Certain embodiments alsoprovide for combinations of different Omega-3 fatty acid esters inratios of from about 2:1 to about 3.4:1. Other embodiments call for theratio to be more than 2:1 to not more than 3.4:1. Typically, the ratiois about 2.4:1. Certain embodiments provide a method for treating avariety of conditions or disorders that can be treated by administeringsaid Omega-3 fatty acid esters in compositions described hereincomprising the described ratios, optionally with at least one surfaceactive agent, at least one terpene, at least one antioxidant, orcombinations thereof. The compositions described herein minimize severalside effects found in currently marketed compositions containing Omega-3fatty acid esters that can deter a human subject from complying withdosing regimen necessary to treat a condition or disorder treatable byadministration of Omega-3 fatty acid esters. In certain embodiments, thebioavailability of said Omega-3 fatty acid esters when administered ascertain compositions described herein is substantially the same whenadministered with or without food, i.e., substantially independent offood effect, to a human subject in need of such administration.

Thus, certain embodiments call for pharmaceutical compositionscomprising at least one Omega-3 fatty acid ester and at least onesurface active agent; wherein said at least one Omega-3 fatty acid estercomprises at least about 40% (wt/wt) of the composition.

Certain embodiments call for pharmaceutical compositions comprising afirst Omega-3 fatty acid ester selected from the group consisting ofhexadecatrienoic acid, α-linolenic acid, stearidonic acid,eicosatrienoic acid, eicosapentaenoic acid, heneicosapentaenoic acid,docosapentenoic acid, docosahexaenoic acid, tetracosapentenoic acid,tetracosahexaenoic acid, and a second Omega-3 fatty acid ester selectedfrom the group consisting of hexadecatrienoic acid, α-linolenic acid,stearidonic acid, eicosatrienoic acid, eicosapentaenoic acid,heneicosapentaenoic acid, docosapentenoic acid, docosahexaenoic acid,tetracosapentenoic acid, tetracosahexaenoic, such that the first andsecond Omega-3 fatty acid esters selected are different from each otherand the ratio of the first and second Omega-3 fatty acid esters are in aratio of more than 2:1 to not more than 3.4:1 (first Omega-3 fatty acidester:second Omega-3 fatty acid ester); wherein the first and secondOmega-3 fatty acid esters combined comprise at least about 40% (wt/wt)of the composition and wherein said composition is substantially free ofactive ingredients other than said Omega-3 fatty acid esters.

Certain embodiments call for the use of at least one Omega-3 fatty acidester. Typically, the Omega-3 fatty acid ester is an ethyl ester.

Certain embodiments call for pharmaceutical compositions comprising atleast one Omega-3 fatty acid ester and at least one terpene; whereinsaid at least one Omega-3 fatty acid ester comprises at least about 40%(wt/wt) of the composition and is substantially free of activeingredients other than Omega-3 fatty acid esters. In certainembodiments, the at least one Omega-3 fatty acid ester comprises about40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%. The terpene is typically, butnot necessarily d-limonene. In certain other embodiments, suchcompositions comprise natural orange-oil.

Certain embodiments provide for compositions comprising EPA ethyl estersand DHA ethyl esters and at least one terpene, wherein the ratio ofEPA:DHA is about 2.4:1 and wherein said EPA and DHA ethyl esterscombined comprise from about 40% (wt/wt) to about 95% (wt/wt) of saidcomposition. In certain embodiments, the EPA and DHA ethyl esterscombined comprise about 40% (wt/wt) of said composition. The terpene istypically, but not necessarily d-limonene. In certain other embodiments,such compositions comprise natural orange-oil.

In embodiments comprising substantially pure d-limonene, the d-limoneneis from about 95% to about 98% pure. In certain embodiments, thesubstantially pure d-limonene is at least 95%, 96%, 97% or 98% pure.

In certain embodiments, the Omega-3 fatty acid ester is selected fromthe group consisting of at least one EPA ester, at least one DHA esteror combinations thereof, and comprises at least one surface activeagent. In certain embodiments, the at least one EPA ester and at leastone DHA ester is substantially pure. Certain embodiments also providefor compositions comprising at least one EPA ester and at least one DHAester in ratios from about 2:1 to about 3.4:1, which are substantiallyfree of active ingredients other than Omega-3 fatty acid esters.Compositions comprising other ratios are also described. Certaincompositions can also be free of natural orange oil or d-limonene. Incertain embodiments, the Omega-3 fatty acid esters comprise at least 40%of the composition. Typically, the Omega-3 EPA and DHA esters are ethylesters. Certain compositions described herein form micelles in anaqueous medium and are free of food effect. Certain compositions, whenadministered with or without food, are substantially free of foodeffect. Provided herein are also methods for treating cardiovascularconditions or disorders using the compositions described. Thecompositions described herein minimize or eliminate side effects whencompared to the administration of prior art compositions. Also providedare packaged compositions or kits of the Omega-3 fatty acid esterscomprising one or more unit dosage forms together with instructions onusing the compositions.

Accordingly, in at least one embodiment is provided, a pharmaceuticalcomposition comprising at least one EPA ester and at least one DHA esterin a weight to weight ratio of more than about 2:1 to not more thanabout 3.4:1 (EPA:DHA) and at least one surface active agent, whereinsaid EPA and DHA esters combined comprises from about 40% to about 85%by weight of the composition. In certain such embodiments, the EPA andDHA ethyl esters combined comprise about 50% (wt/wt) of saidcomposition.

In at least one other embodiment is provided, a pharmaceuticalcomposition comprising at least one EPA ester and at least one DHA esterin a weight to weight ratio from about 2:1 to about 3.4:1 (EPA:DHA) andat least one surface active agent, wherein said EPA and DHA esterscombined comprises from about 40% to about 85% by weight of thecomposition. In certain such embodiments, the EPA and DHA ethyl esterscombined comprise about 50% (wt/wt) of said composition.

In at least one other embodiment is provided, a pharmaceuticalcomposition comprising at least one EPA ester and at least one DHA esterin a weight to weight ratio of more than 2:1 to not more than 3.4:1(EPA:DHA) and at least one surface active agent, wherein said EPA andDHA esters combined comprises from about 40% to about 85% by weight ofthe composition. In certain such embodiments, the EPA and DHA ethylesters combined comprise about 50% (wt/wt) of said composition.

In at least one other embodiment is provided, a pharmaceuticalcomposition comprising at least one EPA ester and at least one DHA esterin a weight to weight ratio of more than 2:1 to not more than 3.4:1(EPA:DHA) and at least one surface active agent, wherein said EPA andDHA esters combined comprises from about 40% to about 85% by weight ofthe composition, and wherein the composition when administered with orwithout food to a human subject in need of such administration issubstantially independent of food effect. In certain such embodiments,the EPA and DHA ethyl esters combined comprise about 50% (wt/wt) of saidcomposition.

In at least one embodiment, the compositions described herein comprisesubstantially pure at least one EPA ester and/or at least one DHA ester.

In at least one embodiment, the compositions described herein consistessentially of the at least one EPA ester and/or the at least one DHAester.

In certain embodiments, either of, or each of, the EPA and DHA estercomprising the composition is the ethyl ester.

In certain embodiments, the compositions described herein comprisesubstantially pure EPA ethyl ester and/or substantially pure DHA ethylester.

In certain embodiments, the compositions described herein consistessentially of substantially pure EPA ethyl ester and/or substantiallypure DHA ethyl ester.

In certain embodiments, the ratio of the EPA and DHA ester comprisingthe composition is about 2.4:1 (EPA ester:DHA ester).

Certain embodiments call for compositions comprising either naturalorange oil from about 0.1% to about 5% (wt/wt) of said composition. Inembodiments comprising natural orange oil the natural orange oil ispresent at about 1.6% (wt/wt) of the composition. Certain otherembodiments comprise substantially pure d-limonene from about 0.1% toabout 5%. In embodiments comprising substantially pure d-limonene, thed-limonene is present at about 1.5% (wt/wt) of the composition.

In certain embodiments, the pharmacologic effect of the compositionsdescribed herein is substantially independent of a food effect uponadministration to a subject.

In at least one embodiment, a pharmaceutical mixed-fatty-acidscomposition in which, a) at least 80% by weight of the composition iscomprised of a combination of (all-Zomega-3)-5,8,11,14,17-eicosapentaenoic acids (EPA) and (all-Zomega-3)-4,7,10,13,16,19-docosahexaenoic acids (DHA) in a weight ratioof EPA:DHA of from about 1:2 to about 2:1; b) (all-Zomega-3)-6,9,12,15,18-heneicosapentaenoic acid is present in an amountof at least one percent by weight; and c) at least one surface activeagent is provided. These compositions can optionally further comprisenatural orange oil from about 0.1% to about 5% (wt/wt) or substantiallypure d-limonene from about 0.1% to about 5% (wt/wt) of the composition.The natural orange oil is typically present at about 1.6% (wt/wt) ofsaid composition and d-limonene is typically present at about 1.5%(wt/wt) of the composition.

In at least one embodiment, a mixed-fatty-acids composition for thetreatment or prophylaxis of at least one of the multiple risk factorsfor CVD in which, a) at least 80% by weight of the composition iscomprised of Omega-3 fatty acids; b) at least 80% by weight of the totalfatty acid content of the composition is comprised of a combination of(all-Z omega-3)-5,8,11,14,17-eicosapentaenoic acid (EPA) and (all-Zomega-3)-4,7,10,13,16,19-docosahexaenoic acid (DHA) in a weight ratio ofEPA:DHA of from 1:2 to 2:1, c) Omega-3 fatty acids other than EPA andDHA are present in an amount of at least 1.5% by weight of the totalfatty acids; and c) at least one surface active agent is provided. Thesecompositions can optionally further comprise natural orange oil fromabout 0.1% to about 5% (wt/wt) or substantially pure d-limonene fromabout 0.1% to about 5% (wt/wt) of the composition. The natural orangeoil is typically present at about 1.6% (wt/wt) of said composition andd-limonene is typically present at about 1.5% (wt/wt) of thecomposition.

In at least one embodiment a pharmaceutical mixed-fatty-acidscomposition in which, a) at least 80% by weight of the composition iscomprised of a combination of (all-Zomega-3)-5,8,11,14,17-eicosapentaenoic acid (EPA) and (all-Zomega-3)-4,7,10,13,16,19-docosahexaenoic acid (DHA) in a weight ratio ofEPA:DHA of from 1:2 to 2:1, b) at least 3% by weight of the compositionis comprised of Omega-3 fatty acids other than EPA and DHA that have 18,20, 21, or 22 carbon atoms, and c) at least one surface active agent isprovided. These compositions can optionally further comprise naturalorange oil from about 0.1% to about 5% (wt/wt) or substantially pured-limonene from about 0.1% to about 5% (wt/wt) of the composition. Thenatural orange oil is typically present at about 1.6% (wt/wt) of saidcomposition and d-limonene is typically present at about 1.5% (wt/wt) ofthe composition.

In at least one embodiment, a pharmaceutical mixed-fatty-acidscomposition in which, a) at least 90% by weight of the composition iscomprised of long chain, polyunsaturated, Omega-3 fatty acids; b) atleast 80% by weight of the composition is comprised of a combination of(all-Z omega-3)-5,8,11,14,17-eicosapentaenoic acid (EPA) and (all-Zomega-3)-4,7,10,13,16,19-docosahexaenoic acid (DHA) in a weight ratio ofEPA:DHA of from 1:1 to 2:1, with the EPA constituting 40 to 60% byweight of the composition and the DHA constituting 25 to 45% by weightof the composition; c) at least 4.5% by weight of the composition iscomprised of Omega-3 fatty acids other than EPA and DHA that have 18,20, 21, or 22 carbon atoms; d) from 1 to 4% by weight of the compositionis comprised of (all-Z omega-3)-6,9,12,15,18-heneicosapentaenoic acid;e) at least one surface active agent; and f) the composition is in oraldosage form and includes an effective amount of a pharmaceuticallyacceptable antioxidant. These compositions can optionally furthercomprise natural orange oil from about 0.1% to about 5% (wt/wt) orsubstantially pure d-limonene from about 0.1% to about 5% (wt/wt) of thecomposition. The natural orange oil is typically present at about 1.6%(wt/wt) of said composition and d-limonene is typically present at about1.5% (wt/wt) of the composition.

It should be noted that in all of the embodiments comprisingcompositions described herein, the total of all ingredients comprisingthe composition does not exceed 100%.

In certain embodiments is provided, a pharmaceutical or drug compositioncomprising EPA and DHA in a weight to weight ratio of about 3.5:1 toabout 5:1 and at least one surface active agent, and wherein thecomposition is more than 84% combined EPA and DHA by weight. Thesecompositions can optionally further comprise natural orange oil fromabout 0.1% to about 5% (wt/wt) or substantially pure d-limonene fromabout 0.1% to about 5% (wt/wt) of the composition. The natural orangeoil is typically present at about 1.6% (wt/wt) of said composition andd-limonene is typically present at about 1.5% (wt/wt) of thecomposition.

Certain embodiments provide for certain compositions comprising at leastabout 96% by weight, ethyl eicosapentaenoate (ethyl-EPA), at least onesurface active agent, substantially no docosahexaenoic acid (DHA) or itsesters. These compositions can optionally further comprise naturalorange oil from about 0.1% to about 5% (wt/wt) or substantially pured-limonene from about 0.1% to about 5% (wt/wt) of the composition. Thenatural orange oil is typically present at about 1.6% (wt/wt) of saidcomposition and d-limonene is typically present at about 1.5% (wt/wt) ofthe composition.

In at least one embodiment, a method is provided for treating thefollowing disorders: metabolic syndrome, macular degeneration, Omega-3deficiency, cognitive impairment, including as a result of surgery ortraumatic brain injury (such as, for example, resulting from aconcussion), major depression, suicide, post-partum depression,inflammation, primary sclerosing cholangitis, borderline personalitydisorder in women, breast cancer, non-alcoholic fatty acid liverdisease, and improvement in cognition and behavior in children. Theseconditions or disorders can be treated by administering the compositionsdescribed herein to a subject, typically a human, in need of suchadministration.

In at least one embodiment, a method is provided for treating at leastone cardiovascular condition or disorder in a subject in need of suchtreatment, said method comprising administering to a subject at leastone composition described herein comprising a therapeutically effectiveamount of the Omega-3 fatty acid esters and at least one surface activeagent.

In at least one embodiment a method is provided for treating at leastone cardiovascular condition or disorder, for example and withoutlimitation disorders of the heart and vasculature, including, forexample, hypertension, hyperlipidemia, hypertriglyceridemia,atherosclerosis, transient ischemic attack, systolic dysfunction,diastolic dysfunction, aneurysm, aortic dissection, myocardial ischemia,acute myocardial infarction (AMI), acute ST-segment elevation myocardialinfarction (STEMI), acute non-ST-segment elevation myocardial infarction(NSTEMI), angina pectoris, unstable angina (UA), and stable angina (SA),myocardial infarction, congestive heart failure, dilated congestivecardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy,corpulmonale, arrhythmia, valvular heart disease, endocarditis,pulmonary embolism, venous thrombosis, peripheral vascular disease, andperipheral artery disease. The method comprises administering to asubject in need of treatment a therapeutically effective amount of acomposition described herein.

In at least one embodiment, a method is provided for treatinghypertension and/or hyperlipidemia.

In at least one other embodiment, a method is provided for treatinghypertriglyceridemia.

In certain embodiments, the total amount of triglycerides (TG) in ahuman subject's blood having ≧150 mg TG per dL of serum at the start ofthe dosing regimen is reduced by at least 20% within about 30 daysfollowing administration of certain embodiments of the compositionsdescribed herein.

In at least one other embodiment, a method is provided for treating ahuman subject having ≧150 mg TG per dL of serum who is in need of suchtreatment, said method comprising administering to the human subject atleast one embodiment of the composition described herein comprising atherapeutically effective amount of Omega-3 fatty acid esters.

Embodiments are also provided wherein the compositions described hereinare packaged together as a kit with instructions on how to use thecompositions for treating cardiovascular conditions or disorders.

In certain embodiments, the surface active agent is selected from thegroup consisting of at least one nonionic surface active agents,cationic surface active agents, anionic surface active agents,zwitterionic surface active agents, or combinations thereof

In certain embodiments, the surface active agent is selected from thegroup consisting of at least one anionic surface active agent, at leastone non-ionic surface active agent, and a combination thereof.

In certain embodiments comprising at least one surface active agent, theat least one surface active agent has a hydrophilic-lipophilic balance(HLB) of about 8.0.

In certain embodiments comprising at least one surface active agent, thesurface active agent can be a non-ionic surface active agent selectedfrom the group consisting of at least one polysorbate, at least onepoloxamer, and a combination thereof.

In certain embodiments, the at least one surface active agent comprisesa polysorbate present from about 15% wt/wt to about 31% wt/wt of thecomposition. In certain embodiments, the polysorbate is polysorbate 80.

In certain other embodiments, the at least one surface active agentcomprises a poloxamer present from about 0.1% to about 5% wt/wt of thecomposition.

In certain embodiments, the compositions described herein comprise acombination of polysorbate 80 and the poloxamer Pluronic F87[(HO(C₂H₄O)₆₄(C₃H₆O)₃₇(C₂H₄O)₆₄H].

In certain embodiments, the composition further comprises at least oneantioxidant. In such embodiments the at least one antioxidant isselected from the group consisting of a tocopherol, a tocotrienol, orcombinations thereof. In such embodiments, the tocopherol, tocotrienolor combinations thereof is present from about 0.01% to about 5% byweight of the compositions. In certain such embodiments, thetocopherols, tocotrienols or combinations thereof can be present atabout 0.01%, 0.05%, 0.1%, 0.2%, 0.3%, 0.4%, 0.5%, 0.6%, 0.7%, 0.8%,0.9%, 1%, 1.5%, 2%, 2.5%, 3%, 3.5%, 4%, 4.5% or 5% by weight of thecompositions. In certain such embodiments, the tocopherols,tocotrienols, or combinations thereof can be present at about 0.4% byweight of the compositions. In certain embodiments, the tocopherol,tocotrienol or combinations is present at about 0.4% by weight of thecomposition. In certain embodiments further comprising at least oneantioxidant, the antioxidant is a tocopherol at about 0.4% by weight ofthe composition.

In certain embodiments, the composition self-micellizes in an aqueousmedium. In certain other embodiments, the aqueous medium is water. Incertain other embodiments, the aqueous medium has an acidic pH. Incertain other embodiments, the aqueous medium is 0.1N HCl.

In certain embodiments, the compositions described hereinself-micellizes in an aqueous medium wherein the micelles have adiameter from about 1 μm to about 10 μm. In certain embodiments, thecompositions described herein self-micellizes in an aqueous mediumhaving an acidic pH, wherein the micelles have a diameter from about 1μm to about 10 μm. In certain other embodiments, the compositionsdescribed herein self-micellizes in 0.1N HCL, wherein the micelles havea diameter from about 1 μm to about 10 μm. In certain embodiments, themicelles have an average diameter of about 1, 2, 3, 4, 5, 6, 7, 8, 9, or10 μm.

In certain embodiments, the compositions described herein can beadministered with or without food to a human subject in need of suchadministration wherein the bioavailability of the Omega-3 fatty acidesters comprising the compositions are substantially independent of foodeffect.

Certain embodiments provide for compositions that minimize or eliminateat least one side effect from the administration of a composition of thepresent disclosure when compared to the administration of a compositioncomprising Omega-3 fatty acid esters substantially free of a surfaceactive agent. In other embodiments, non-limiting examples of the sideeffects include regurgitation, frequency of burping, gastroesophagealreflux disease (GERD), bloating, increased intestinal gas, fish taste,fishy breath, fish smell, nausea, diarrhea, or combinations thereof.

In certain embodiments, the compositions described herein comprised-limonene or natural orange oil. Such compositions can minimize oreliminate at least one side effect from the administration of acomposition of the present disclosure when compared to theadministration of a composition comprising Omega-3 fatty acid esterssubstantially free of d-limonene or natural orange oil. In otherembodiments, non-limiting examples of the side effects includeregurgitation, frequency of burping, gastroesophageal reflux disease(GERD), bloating, increased intestinal gas, fish taste, fishy breath,fish smell, nausea, diarrhea, or combinations thereof.

In certain embodiments, the compositions described herein whenadministered to a human subject selected from the group consisting ofindividuals having from about 155 to about 199 mg TG per dL of serum,from about 200 to about 499 mg TG per dL of serum and from about 500 mgor higher TG per dL of serum, lowers said subject's serum TG levels byat least about 20%.

Certain embodiments of the compositions described herein can beadministered to a human subject in need of such administration with anon-Omega-3 fatty acid ester lipid-lowering agent selected from thegroup consisting of cholesterol absorption inhibitors, bile acidsequestrants/resins, statins, niacin and derivatives, MTP inhibitors,fibrates and CETP inhibitors.

In certain embodiments, the compositions described herein can reduce thetotal amount of TG in the serum of a human subject being treated forhypertriglyceridemia by at least about 20% within about 30 days ofadministration of the composition wherein the human subject's bloodmeasures >150 mg TG per dL of serum at the start of the dosing regimen.

In at least one embodiment, the compositions described herein can beadministered orally or parenterally in a suitable dosage form. Whenadministered orally, the compositions described herein can beadministered, typically, but not necessarily, in the form of a gel orliquid capsule.

In certain other embodiments, methods are provided for administering atleast about 0.5 g/day of certain embodiments of the compositionsdescribed herein comprising from about 40% to about 85% by weight of thecomposition, at least one EPA ester and at least one DHA ester in aratio of more than 2:1 to not more than 3.4:1 and at least one surfaceactive agent. Typically, but not necessarily, the ester is an ethylester and the at least one surface active agent is polysorbate 80,Pluronic F87 or a combination thereof. In certain such embodiments, theEPA and DHA ethyl esters combined comprise about 50% (wt/wt) of saidcomposition. Optionally, the composition can further comprisesubstantially pure d-limonene or natural orange oil.

In certain other embodiments, methods are provided for administering atleast about 4 g/day of certain embodiments of the compositions describedherein comprising ethyl eicosapentaenoic acid (ethyl-EPA), at least onesurface active agent and substantially no docosahexaenoic acid (DHA),where the ethyl-EPA constitutes at least about 96% by weight of thetotal Omega-3 fatty acid esters in the composition. In certainembodiments, such compositions can further comprise natural orange oilor substantially pure d-limonene.

Certain embodiments provide for the use of the compositions describedherein in the manufacture of a medicament for the treatment of acardiovascular disease or disorder. In certain embodiments, thecardiovascular disease or disorder is hyperlipidemia. In certain otherembodiments, the cardiovascular disease or disorder ishypercholesterolemia. In certain embodiments, the cardiovascular diseaseor disorder is hypertriglyceridemia.

Certain embodiments provide for the use of the compositions describedherein in the manufacture of a medicament for the treatment of acardiovascular disease or disorder. In certain embodiments, thecardiovascular disease or disorder is hyperlipidemia. In certain otherembodiments, the cardiovascular disease or disorder ishypercholesterolemia. In certain embodiments, the cardiovascular diseaseor disorder is hypertriglyceridemia.

In certain embodiments, administration of the compositions describedherein provide for a blood serum concentration in a human subject of atleast about 20 nmol/mL of combined at least one EPA ester and at leastone DHA ester within about four hours after administration of thecertain embodiments.

Also provided are kits comprising compositions of the Omega-3 fatty acidesters as one or more unit dosage forms together with instructions onusing the dosage forms. In certain embodiments, the dosage formsdescribed herein can be packaged as blister packs or in bottles withinstructions for using the dosage forms. For example, the instructionscan be provided as a package insert or directly on a label attached tothe blister pack, bottle or on secondary packaging in which the blisterpack or bottle was provided to a human subject. The instructions caninclude, for example, dosing frequency, administration of the dosageforms with or without food, the active ingredients comprising the dosageforms, and the cardiovascular conditions or disorders that would benefitfrom administration of the dosage forms.

In certain embodiments kits are provided, wherein certain dosage formscomprising the compositions described herein can be packaged togetherwith other non-Omega-3 fatty acid ester lipid lowering agents. Thekit(s) comprise one or more unit dosage forms of certain embodiments ofthe compositions described herein together with one or more unit dosageforms comprising the non-Omega-3 fatty acid ester lipid-lowering agentstogether with instructions on using the dosage forms.

Certain embodiments provide for a functional food(s) for treating and/orpreventing CVD comprising the compositions described herein.

Certain embodiments provide methods of treating CVD by administering afunctional food comprising the compositions described herein.

Certain embodiments provide for a functional food(s) comprising thecompositions described herein, and methods to treat hypertriglyceridemiain a human subject.

BRIEF DESCRIPTION OF THE DRAWING

FIG. 1 depicts a photomicrograph of an embodiment. A compositioncomprising micelles, as described herein, was prepared, added between aslide and cover slip, observed at 40× magnification with a Nikon ModelTrinocular Head and a Spot RT3 digital camera, and the diameters ofseveral representative micelles were measured.

FIG. 2 shows a schematic flowchart of the process for manufacturing oneembodiment of the compositions described herein.

FIG. 3 shows a schematic flowchart of the process for manufacturing thegel mass for encapsulating one embodiment of the compositions describedherein.

FIG. 4 shows the a schematic flowchart of the encapsulation process formanufacturing one dosage form comprising one embodiment of thecompositions described herein.

DETAILED DESCRIPTION

Certain aspects, modes, embodiments, variations and features of theinvention are described herein in various levels of detail to providefurther understanding of embodiments related to compositions comprisingOmega-3 fatty acid esters, and methods related to using suchcompositions containing a high concentration of Omega-3 fatty acidesters. In certain embodiments, an EPA ester and DHA ester are presentin specific weight ratio percentages and relative amounts. As noted,these compositions have beneficial effects on certain risk factors forCVD, including the lowering of serum triglycerides and serumcholesterol.

DEFINITIONS

As used herein, the term “composition(s)” or “formulation(s)” includestherapeutic and dietary compositions including, but not limited to adietary supplement, nutraceutical formulation, or pharmaceuticalformulation. Further, the terms composition, dietary supplement,nutraceutical formulation, and pharmaceutical formulation are usedinterchangeably herein.

As used herein, the term “EPA” refers inclusively to(5Z,8Z,11Z,14Z,17Z)-eicosa-5,8,11,14,17-pentenoic acid or derivativesthereof, including alkyl esters, such as, for example, the ethyl ester.

As used herein, the term “DHA” inclusively refers to(4Z,7Z,10Z,13Z,16Z,19Z)-docosa-4,7,10,13,16,19-hexaenoic acid orderivatives thereof, including alkyl esters, such as, for example, theethyl ester.

As used herein, the term “micelle” (plural micelles, micella, ormicellae) refers to an aggregate of molecules, that have assembled intoan approximately spherical core/shell architecture, and are suspended inan aqueous phase. A typical micelle in aqueous solution forms anaggregate with the hydrophilic “head” regions in contact withsurrounding solvent and/or in contact with the polar region of one ormore surface active agent(s), sequestering the hydrophobic regions inthe micelle center. Micelles are approximately spherical in shape.

The term “self-micellizes” as used herein refers to the process in whichmicelles are formed in an aqueous medium without the introduction ofenergy, including agitation or shearing.

As used herein, the term “aqueous medium” refers to any solution orsuspension, that comprises water, including for example, withoutlimitation, water by itself; phosphate buffered saline pH 7.4, Sprite,apple juice, G-2 fruit punch, and chocolate milk. In certainembodiments, an aqueous medium comprises at least one fluid having anacidic pH. In certain other embodiments, an aqueous medium comprises abiological fluid such as, for example and without limitation, stomachacid. In other embodiments, the aqueous medium comprises simulatedstomach acid comprising 0.1N HCl.

As used herein, the term “free fatty acid” refers to one or morepolyunsaturated fatty acids that have not been modified or do not haveany other groups attached.

As used herein, the term “ester” refers to the replacement of thehydrogen in the carboxylic acid group of a polyunsaturated fatty acidmolecule with another substituent. Typical esters are known to those inthe art, a discussion of which is provided by Higuchi, T. et al.,Pro-drugs as Novel Delivery Systems, Vol. 14, A.C.S. Symposium Series,Bioreversible Carriers in Drug Design, Ed. Edward B. Roche, Amer.Pharma. Assoc., Pergamon Press (1987), and Protective Groups in OrganicChemistry, McOmie ed., Plenum Press, New York (1973), each of which isincorporated herein by reference in the entirety. Examples of commonesters include methyl, ethyl, trichloroethyl, propyl, butyl, pentyl,tert-butyl, benzyl, nitrobenzyl, methoxybenzyl, benzhydryl,monoglyceride, diglyceride, triglyceride.

As used herein, the term “monoglyceride” refers to a fatty acid chain,such as DHA or EPA molecule, covalently bonded to a glycerol moleculethrough an ester linkage. As used herein, the term “diglyceride” refersto a fatty acid chain such as DHA or EPA, covalently bonded to aglycerol molecule through an ester linkage, wherein the glycerolmolecule is further bonded to one additional fatty acid chain, which mayor may not be DHA or EPA, through one additional ester linkage. As usedherein, the term “triglyceride” refers to a fatty acid chain, such asDHA or EPA, covalently bonded to a glycerol molecule through an esterlinkage, wherein the glycerol molecule is further bonded to twoadditional fatty acid chains, either or both of which may or may not beDHA or EPA, through two additional ester linkages.

As used herein, the term “terpene” refers to the large and diverse classof organic compounds produced by a variety of plants, particularlyconifers. When terpenes are modified chemically, such as by oxidation orrearrangement of the carbon skeleton, the resulting compounds aregenerally referred to as “terpenoids” (e.g., carvone). Terpenes andterpenoids are the primary constituents of the essential oils of manytypes of plants and flowers.

As used herein, the terms “α-Tocopherol,” “tocopherol,” and “vitamin E”each refer to a set of tocopherols and tocotrienols, which arefat-soluble vitamins with antioxidant properties.

As used herein, the term “antioxidant” refers to a molecule capable ofinhibiting the oxidation of other molecules. Oxidation is a chemicalreaction that transfers electrons or hydrogen from a substance to anoxidizing agent. Oxidation reactions can produce free radicals. In turn,these radicals can start chain reactions. When the chain reaction occursin a cell, it can cause damage or death to the cell. Antioxidantsterminate these chain reactions by removing free radical intermediates,and inhibit other oxidation reactions. They do this by being oxidizedthemselves, so antioxidants are often reducing agents such as thiols,ascorbic acid, or polyphenols. Exemplary antioxidants include rosemaryoil, ascorbic acid (vitamin C), glutathione, lipoic acid, uric acid,carotenes, melatonin, ubiquinol (coenzyme Q), α-tocopherol (vitamin E),acorbyl palmitate, butylated hydroxyanisole, butylated hydroxytoluene,monothioglycerol, and potassium metabisulfite.

As used herein, a pharmaceutically acceptable “carrier” refers to anysubstance suitable as a vehicle for delivering a molecule or compositionto a suitable in vivo site of absorption. Examples of such carriersinclude, but are not limited to water, phosphate buffered saline (PBS),Ringer's solution, dextrose solution, serum-containing solutions, Hank'ssolution and other aqueous physiologically-balanced solutions.

As used herein, a pharmaceutically acceptable “preservative” includesbut is not limited to potassium sorbate, methylparaben, propylparaben,benzoic acid and its salts, other esters of parahydroxybenzoic acid suchas butylparaben, alcohols such as ethyl or benzyl alcohol, phenoliccompounds such as phenol, or quarternary compounds such as benzalkoniumchloride.

As used herein, a “coloring agent” provides coloration to thecomposition or dosage form. Such coloring agents include food gradedyes.

As used herein, the term “subject” refers to a mammal, including but notlimited to a dog, cat, horse, cow, pig, sheep, goat, chicken, rodent,primate or human. Subjects include animals such as house pets (e.g.,dogs, cats, and the like), agricultural stock subjects (e.g., cows,horses, pigs, chickens, etc.), laboratory subjects (e.g., mice, rats,rabbits, etc.), but are not so limited. The human subject may be apediatric, adult, or a geriatric subject. The human subject may be ofeither gender.

As used herein, the terms “cardiovascular disease” and “cardiovascularcondition” include disorders of the heart and vasculature, including,for example, hypertension, hyperlipidemia, hypertriglyceridemia,atherosclerosis, transient ischemic attack, systolic dysfunction,diastolic dysfunction, aneurysm, aortic dissection, myocardial ischemia,acute myocardial infarction (AMI), acute ST-segment elevation myocardialinfarction (STEMI), acute non-ST-segment elevation myocardial infarction(NSTEMI), angina pectoris, unstable angina (UA), and stable angina (SA),myocardial infarction, congestive heart failure, dilated congestivecardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy,corpulmonale, arrhythmia, valvular heart disease, endocarditis,pulmonary embolism, venous thrombosis, peripheral vascular disease, andperipheral artery disease.

Hypertriglyceridemia, for example, is a condition related tocardiovascular disease in which fasting blood serum concentrations oftriglycerides are ≧150 mg/dL. Blood concentrations can rise frommoderately high levels of 200 mg/dL to 500 mg/dL, or in severe cases,above 500 mg/dL. The American Heart Association has categorizedtriglyceride concentrations as “normal” (below 150 mg/dL), “elevated”(150 to 199 mg/dL), “high” (200 to 499 mg/dL), and “very high” (above500 mg/dL). It will be evident to the skilled practitioner that thecategorization of hypertriglyceridemia can vary from country to country.For example, Canadian and European guidelines recommend fasting bloodserum triglyceride levels of less than 1.7 mmol/L as “desirable”, from1.7 to 2.2 mmol/L as “borderline high” and 2.3 to 5.6 mmol/L as “high”and above 5.6 mmol/L as “very high”. The skilled practitioner will alsoappreciate that what constitutes elevated blood serum triglyceridelevels may vary based on age and gender.

As used herein, an “effective amount” or “therapeutically effectiveamount” of a composition as described in some embodiments herein can bea quantity sufficient to achieve a desired therapeutic and/orprophylactic effect, for example, an amount which results in theprevention of, or a decrease in the symptoms associated with, a diseasethat is being treated. The amount of composition administered to thesubject, particularly one in need of the composition, can depend on thetype and severity of the disease and on the characteristics of theindividual, such as general health, age, sex, body weight and toleranceto drugs. A person skilled in the art will be able to determineappropriate dosages depending on these and other factors. Typically, aneffective amount of the compositions described herein can be sufficientfor achieving a therapeutic or prophylactic effect.

The terms “dose unit,” “unit dose,” and “dosage unit,” as used herein,refer to a portion of a composition that contains an effective amount ofan active suitable for a single administration to provide, or contributeto, a therapeutic effect. Such dosage units may be administered one to aplurality (i.e., 1 to about 10, 1 to 8, 1 to 6, 1 to 4 or 1 to 2) oftimes per day, or as many times as needed to elicit a therapeuticresponse.

The term “food effect,” as used herein, refers to a relative differencein AUC (area under the curve), C_(max) (maximum plasma concentration),and/or T_(max) (time to maximum concentration) of an active substance,when said substance or a composition thereof, such as a tablet, acapsule or a liquid, is administered orally to a subject concomitantlywith food or in a fed state as compared to the same values when the samecomposition is administered in a fasted state. The food effect, F, iscalculated as:

F=(Y _(fed) −Y _(fasted))/Y _(fasted)

wherein Y_(fed) and Y_(fasted) are the found values of AUC, C_(max), orT_(max) in the fed and fasted state, respectively. A food effect, F, isgenerally established when F>1.

In general, the term “AUC” or “area under the plasma concentration-timecurve” is related to the total amount of an active measurable in thesystemic circulation following administration of a single dose. The AUCis a mathematical and visual representation of the aggregate amount ofthe active in the systemic circulation over a given period of time.Changes in the AUC need not necessarily reflect changes in the totalamount of the active absorbed but can reflect modifications in thekinetics of distribution, metabolism and excretion. Accordingly, theterm AUC as used herein refers to the total amount of Omega-3 fattyacids measurable in the systemic circulation following administration ofa single dose of any of the compositions described herein.

The term “T_(max)” or “time of peak concentration” refers to the periodof time required to achieve peak plasma concentration of an active afteradministration of a single dose. Accordingly, the term T_(max) as usedherein refers to the period of time required to achieve peak plasmaconcentration of Omega-3 fatty acid esters after administration of asingle dose of any of the compositions described herein.

The term “C_(max)” or “peak concentration” is the highest concentrationof an active achieved in the blood plasma. Accordingly, the term C_(max)as used herein refers to the maximum concentration of Omega-3 fatty acidesters after administration of a single dose of any of the compositionsdescribed herein.

The term “substantially independent of a food effect,” or “substantiallyfree of food effect” as used herein, refers to a substantial eliminationof the effect of food upon the absorption (e.g., F is about 0),following oral administration, of any of the compositions describedherein. In other words, the bioavailability of the Omega-3 fatty acidesters, as measured by the logarithm-transformed AUC, is substantiallythe same regardless of whether the compositions described herein areadministered with or without food. In certain embodiments, thepharmacological effects of administration of compositions describedherein are substantially independent of a food effect.

The term “reduced food effect,” as used herein, as used herein, refersto a substantial reduction in the effect of food upon the absorption,following oral administration, of any of the compositions described. Incertain embodiments, the compositions described herein have a reducedfood effect.

The term “concomitantly with food” or “administration in the fed state,”as used herein, refers to administration from about 30 minutes before ameal to about 1 hour after a meal.

Various modes of treatment or prevention of medical conditions asdescribed herein are intended to mean “substantial” or “substantially”,which includes total but also less than total treatment or prevention,and wherein some biologically or medically relevant result is achieved.A subject, such as a human subject, in need of treatment refers to asubject in need of treatment of a defined disease state or in need ofpreventative treatment (i.e., prophylaxis) of such a disease state.

The term “about” or “approximately” as used herein means within anacceptable error range for the particular value as determined by one ofordinary skill in the art, which will depend in part on how the value ismeasured or determined, i.e., the limitations of the measurement system.Where particular values are described in the application and claims,unless otherwise stated, the term “about” means within an acceptableerror range for the particular value.

The term “active(s)”, “active ingredient(s)”, “active agents” or“pharmaceutically active ingredient” means a chemical entity intended tofurnish pharmacological activity or to otherwise have direct effect inthe diagnosis, cure, mitigation, treatment or prevention of disease, orto have direct effect in restoring, correcting or modifyingphysiological functions in a subject.

The term “functional food” as used herein means any edible or drinkablefoods or dietary components (e.g., juices, milk, yogurt, butter,margarine, baking products) that are fortified or enhanced with any ofthe compositions described herein. The functional food can be, e.g.,solid, liquid, semisolid, or a combination thereof. The term “functionalfood” also encompasses edible and drinkable nutritional supplements.

The term “hydrophilic-lipophilic balance” or “HLB,” as used herein,refers to the relative affinity of a substance or composition foraqueous and oily phases. HLB values can be calculated based on methodsand equations known to those of ordinary skill in the art, such as thosedescribed in U.S. Pat. No. 5,585,192. Substances or compositionsgenerally have an average HLB of about 6 to about 20.Hydrophilic-lipophilic balance values can be determined in a variety ofthe formulas or experimental methods provided, for example, in U.S. Pat.No. 5,585,192.

The term “substantially pure” as used herein means at least 90% pure.

Pharmaceutical Compositions

In at least one embodiment, a composition is provided, wherein thecomposition comprises at least one Omega-3 fatty acid ester, at leastone surface active agent, and wherein the composition self-micellizeswhen in contact with an aqueous medium. In certain embodiments, said atleast one Omega-3 fatty acid ester comprises from about 40% (wt/wt) toabout 85% (wt/wt) of the composition. In certain embodiments, the atleast one Omega-3 fatty acid ester comprises about 40%, 45%, 50%, 55%,60%, 65%, 70%, 75%, 80% or 85% (wt/wt) of the composition.

In certain embodiments, the compositions described herein self-micellizein 0.1N HCl. It is well accepted that 0.1N HCl (simulated gastricfluid), serves as a proxy for the acidity of stomach contents.Accordingly, and without being bound by theory, it is believed that thecompositions described herein can self-micellize in situ in the stomachor small intestine. In certain embodiments, the compositions describedherein more efficiently and effectively deliver Omega-3 fatty acidesters through the intestinal tract when administered with or withoutfood.

Certain embodiments call for the use of Omega-3 fatty acid esters.Accordingly, in one aspect, a composition is provided comprising atleast one (5Z,8Z,11Z,14Z,17Z)-eicosa-5,8,11,14,17-pentenoic acid (EPA)ester; or at least one(4Z,7Z,10Z,13Z,16Z,19Z)-docosa-4,7,10,13,16,19-hexaenoic acid (DHA)ester; or a combination thereof, wherein the composition has a ratio ofEPA ester to DHA ester of more than 2.0:1.0 to not more than 3.4:1.0 andis substantially free of active ingredients other than said Omega-3fatty acid esters. In certain embodiments, the Omega-3 fatty acid estersin said composition comprise Omega-3 fatty acid ethyl esters. In certainembodiments, the EPA and DHA esters constitute from at least about 40%to about 95% (wt/wt) of the total Omega-3 fatty acid esters in thecomposition. In certain embodiments, the EPA and DHA esters compriseabout 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, or 95%(wt/wt) of the total Omega-3 fatty acid esters of the composition.

It has been discovered that compositions comprising Omega-3 fatty acidesters having a ratio of more than 2.0:1.0 to not more than 3.4:1.0 ofalkyl (5Z,8Z,11Z,14Z,17Z)-eicosa-5,8,11,14,17-pentenoate to alkyl(4Z,7Z,10Z,13Z,16Z,19Z)-docosa-4,7,10,13,16,19-hexaenoate (EPA:DHA) areeffective for the reduction of TG concentrations in blood serum. Incertain embodiments, the EPA and DHA esters comprise at least 40% of thetotal Omega-3 fatty acid esters of the composition. In certainembodiments, the EPA and DHA esters comprise about 40%, 45%, 50%, 55%,60%, 65%, 70%, 75%, 80%, 85%, 90%, or 95% of the total Omega-3 fattyacid esters of the composition. It also has been discovered thatcompositions having Omega-3 fatty acid esters including more than about2.0:1.0 to not more than 3.4:1.0 (EPA:DHA esters) can be formulated withone or more surface active agents to produce compositions thatself-micellize in an aqueous medium. The micelles are generallyuniformly spherical and stable, and provide for absorption of theOmega-3 fatty acid esters substantially free of any food effect. Basedon the observation that the compositions described herein self-micellizein 0.1N HCl, it is believed that the compositions described herein willalso self-micellize in the stomach or small intestine. In certainembodiments, such compositions provide beneficial drug delivery profilesfor Omega-3 fatty acid esters.

In certain embodiments, the compositions described herein, comprisingEPA and DHA esters, eliminate many of the side effects commonlyassociated with administration of Omega-3 fatty acid esters. Thus, thecompositions described herein, comprising EPA and DHA esters, do nothave a bad smell, and/or produce an unpleasant aftertaste, and/or causeburping in the patient. In another aspect, a composition is providedcomprising at least one(5Z,8Z,11Z,14Z,17Z)-eicosa-5,8,11,14,17-pentenoic acid (EPA) ester; orat least one (4Z,7Z,10Z,13Z,16Z,19Z)-docosa-4,7,10,13,16,19-hexaenoicacid (DHA) ester; or a combination thereof, wherein the composition hasa ratio of EPA ester to DHA ester of more than about 2.0:1.0 to not morethan about 3.4:1.0, and at least one surface active agent; wherein saidEPA ester, DHA ester, or a combination thereof, comprises at least 40%of the total amount of Omega-3 fatty acid esters in said composition. Incertain embodiments, the Omega-3 fatty acid esters in said compositioncomprise Omega-3 fatty acid esters. In certain embodiments, the EPA andDHA esters constitute at least from about 40% to about 95% of the totalOmega-3 fatty acid esters of the composition. Accordingly, in certainembodiments, the EPA and DHA esters comprise about 40%, 45%, 50%, 55%,60%, 65%, 70%, 75%, 80%, 85%, 90% or 95% of the total Omega-3 fatty acidesters of the composition.

In certain embodiments, the ratio of EPA fatty acid ester to DHA esteris from more than 2.0:1.0 to not more than 3.4:1.0. In certainembodiments, the ratio of EPA ester to DHA ester is from about 2.0:1 toabout 3.4:1.0. In other embodiments, the ratio of EPA ester to DHA esteris from about 2.0:1.0 to about 3.0:1.0. In other embodiments, the ratioof EPA ester to DHA ester is from about 2.0:1.0 to about 2.7:1.0. Inother embodiments, the ratio of EPA ester to DHA ester is from about2.0:1.0 to about 2.5:1.0. In other embodiments, the ratio of EPA esterto DHA ester is from about 2.0:1.0 to about 2.4:1.0. In otherembodiments, the ratio of EPA ester to DHA ester is from about 2.1:1.0to about 2.3:1.0. In other embodiments, the ratio of EPA ester to DHAester is from about 2.1:1.0 to about 2.2:1.0. In other embodiments, theratio of EPA ester to DHA ester is about 2.4:1.0.

In certain embodiments, said ratio of EPA ester to DHA ester in saidcomposition is about 2.0:1.0. In certain embodiments, said ratio of EPAester to DHA ester in said composition is about 2.1:1.0. In certainembodiments, said ratio of EPA ester to DHA ester in said composition isabout 2.15:1.0. In certain embodiments, said ratio of EPA ester to DHAester in said composition is about 2.2:1.0. In certain embodiments, saidratio of EPA ester to DHA ester in said composition is about 2.3:1.0. Incertain embodiments, said ratio of EPA ester to DHA ester in saidcomposition is about 2.4:1.0. In certain embodiments, said ratio of EPAester to DHA ester in said composition is about 2.5:1.0. In certainembodiments, said ratio of EPA ester to DHA ester in said composition isabout 2.6:1.0. In certain embodiments, said ratio of EPA ester to DHAester in said composition is about 2.7:1.0. In certain embodiments, saidratio of EPA ester to DHA ester in said composition is about 2.8:1.0. Incertain embodiments, said ratio of EPA ester to DHA ester in saidcomposition is about 2.9:1.0. In certain embodiments, said ratio of EPAester to DHA ester in said composition is about 3.0:1.0. In certainembodiments, said ratio of EPA ester to DHA ester in said composition isabout 3.1 1.0. In certain embodiments, said ratio of EPA ester to DHAester in said composition is about 3.2:1.0. In certain embodiments, saidratio of EPA ester to DHA ester in said composition is about 3.3:1.0. Incertain embodiments, said ratio of EPA ester to DHA ester in saidcomposition is about 3.4:1.0.

In certain embodiments, the compositions described herein comprise anOmega-3 fatty acid ester selected from at least one of the followinghexadecatrienoic acid (“HTA” or 16:3 (n-3), orall-Z-7,10,13-hexadecatrienoic acid), a-linolenic acid (“ALA” or 18:3(n-3), or all-Z-9,12,15-octadecatrienoic acid), stearidonic acid (“SDA”or 18:4 (n-3) or all-Z-6,9,12,15-octadecatetraenoic acid),eicosatrienoic acid (“ETE” or 20:3 (n-3) or all-Z-11, 14, 17eicosatrienoic acid), eicosatetraenoic acid (“ETA” or 20:4 (n-3), orall-Z-8,11,14,17-eicosatetraenoic acid), eicosapentaenoic acid (“EPA” or20:5 (n-3) or all-Z-5,8,11,14,17-eicosapentaenoic acid),heneicosapentaenoic acid (“HPA” or 21:5 (n-3) orall-Z-6,9,12,15,18-heneicosapentaenoic acid), docosapentenoic acid(“DPA”, or clupanodonic acid or 22:5 (n-3) orall-Z-7,10,13,16,19-docosapentenoic acid); docosahexaenoic acid (“DHA”or 22:6 (n-3) or all-Z-4,7,10,13,16,19-docosahexaenoic acid),tetracosapentenoic acid (24:5 (n-3) orall-Z-9,12,15,18,21-tetracosapentenoic acid), tetracosahexaenoic acid(nisinic acid or 24:6 (n-3) or all-Z-6,9,12,15,18,21-tetracosahexaenoicacid. In certain embodiments provided herein, the esters comprise anester of (5Z,8Z,11Z,14Z,17Z)-eicosa-5,8,11,14,17-pentenoic acid (EPA),an ester of (4Z,7Z,10Z,13Z,16Z,19Z)-docosa-4,7,10,13,16,19-hexaenoicacid (DHA), or a combination thereof. In certain embodiments, the estersare ethyl esters. In certain embodiments, the esters are a singleOmega-3 fatty acid ester. In certain embodiments, the esters arecombinations of different Omega-3 fatty acid esters, such as thoserecited herein. In certain embodiments, other fatty acids, or dietaryoils can also be present.

In certain embodiments, said Omega-3 fatty acid ester(s) comprise about40% (wt/wt) of said composition. In certain embodiments, said Omega-3fatty acid ester(s) comprise at about 45% (wt/wt) of said composition.In certain embodiments, said Omega-3 fatty acid ester(s) comprise about50% (wt/wt) of said composition. In other embodiments, said Omega-3fatty acid ester(s) comprise about 55% (wt/wt) of said composition. Inother embodiments, said Omega-3 fatty acid ester(s) comprise about 60%(wt/wt) of said composition. In other embodiments, said Omega-3 fattyacid ester(s) comprise about 65% (wt/wt) of said composition. In otherembodiments, said Omega-3 fatty acid ester(s) comprise at about 70%(wt/wt) of said composition. In other embodiments, said Omega-3 fattyacid ester(s) comprise about 75% (wt/wt) of said composition. In otherembodiments, the Omega-3 fatty acid ester(s) comprise about 80% (wt/wt)of said composition. In other embodiments, the Omega-3 fatty acidester(s) comprise about 85% (wt/wt) of said composition. In otherembodiments, the Omega-3 fatty acid ester(s) comprise about 90% (wt/wt)of said composition. In other embodiments, the Omega-3 fatty acidester(s) comprise about 95% (wt/wt) of said composition.

In certain embodiments, the compositions comprise a pharmaceuticalcomposition comprising a first Omega-3 fatty acid ester selected fromthe group consisting of an ester of hexadecatrienoic acid, α-linolenicacid, stearidonic acid, eicosatrienoic acid, eicosapentaenoic acid,heneicosapentaenoic acid, docosapentenoic acid, docosahexaenoic acid,tetracosapentenoic acid, tetracosahexaenoic acid, or combinationsthereof; and a second Omega-3 fatty acid ester selected from the groupconsisting of an ester of hexadecatrienoic acid, α-linolenic acid,stearidonic acid, eicosatrienoic acid, eicosapentaenoic acid,heneicosapentaenoic acid, docosapentenoic acid, docosahexaenoic acid,tetracosapentenoic acid, tetracosahexaenoic acid, or combinationsthereof and at least one surface active agent. The first and secondOmega-3 fatty acid esters to be selected will be different. The ratio ofthe first to second Omega-3 fatty acid esters should be from more than2:1 to not more than 3.4:1 (first Omega-3 fatty acid ester:secondOmega-3 fatty acid ester). Typically, the ratio of the first to secondOmega-3 fatty acid ester is about 2.4:1. The first and second Omega-3fatty acid esters combined comprise from about 40% to about 85% (wt/wt)of the composition. In certain embodiments, the first and second Omega-3fatty acid esters combined comprise at least about 40% (wt/wt) of thecomposition. In certain embodiments, the first and second Omega-3 fattyacid esters combined comprise at least about 45% (wt/wt) of thecomposition. In certain embodiments, the first and second Omega-3 fattyacid esters combined comprise at least about 50% (wt/wt) of thecomposition. In certain embodiments, the first and second Omega-3 fattyacid esters combined comprise at least about 55% (wt/wt) of thecomposition. In certain embodiments, first and second Omega-3 fatty acidesters combined comprise at least about 60% (wt/wt) of the composition.In certain embodiments, the first and second Omega-3 fatty acid esterscombined comprise at least about 65% (wt/wt) of the composition. Incertain embodiments, the first and second Omega-3 fatty acid esterscombined comprise at least about 70% (wt/wt) of the composition. Incertain embodiments, first and second Omega-3 fatty acid esters combinedcomprise at least about 75% (wt/wt) of the composition. In certainembodiments, first and second Omega-3 fatty acid esters combinedcomprise at least about 80% (wt/wt) of the composition. In certainembodiments, first and second Omega-3 fatty acid esters combinedcomprise at least about 85% (wt/wt) of the composition. In certainembodiments, these mixed Omega-3 fatty acid ester compositions aresubstantially free of active ingredients other than said Omega-3 fattyacid esters. These mixed Omega-3 fatty acid ester compositions canfurther comprise at least one terpene and/or at least one antioxidant.The terpene is typically substantially pure d-limonene and is presentfrom about 0.1% to about 5% (wt/wt) of said composition. Optionally, thecomposition can also further comprise natural orange oil from about 0.1%to about 5% (wt/wt) of said composition. The at least one surface activeagent can be any one or more of the surface active agents describedherein, but is typically a polysorbate and/or a poloxamer, such as forexample, polysorbate 80 and Pluronic F87. The surface active agent ispresent from about 15% to about 31% (wt/wt) of the composition. Theantioxidant(s) suitable for use in these mixed Omega-3 fatty acid estercompositions, include, but are not limited to tocopherols and/ortocotrienols and can be present from about 0.01% to about 5% (wt/wt) ofthe composition. In certain such embodiments, the tocopherols and/ortocotrienols can be present at about 0.01%, 0.05%, 0.1%, 0.2%, 0.3%,0.4%, 0.5%, 0.6%, 0.7%, 0.8%, 0.9%, 1%, 1.5%, 2%, 2.5%, 3%, 3.5%, 4%,4.5% or 5% by weight of the compositions. In certain such embodiments,the antioxidant is a tocopherol present at about 0.4% by weight of thecomposition.

In certain embodiments, compositions comprise an Omega-3 fatty acidester, such as an ethyl ester, one or more surface active agents. Incertain embodiments, said surface active agent is selected from thegroup consisting of nonionic surface active agents, cationic surfaceactive agents, anionic surface active agents, zwitterionic surfaceactive agents, or combinations thereof. In some embodiments, thecompositions include one or more non-ionic surface active agents.Non-ionic surface active agents generally have a hydrophobic group and areactive hydrogen atom, for example aliphatic alcohols, acids, amidesand alkyl phenols, with alkylene oxides, especially ethylene oxideeither alone or in combination with propylene oxide. Examples ofnonionic surfactant compounds include, but are not limited to,polyoxyethylene glycol sorbitan alkyl esters, block copolymers ofpolyethylene glycol and polypropylene glycol, ethylene glycol fatty acidesters, poly(ethylene glycol) fatty acid esters, propylene glycol fattyacid esters, poly(propylene glycol) fatty acid esters, glycol fatty acidesters, trimethylolpropane fatty acid esters, pentaerythritol fatty acidesters, glucoside derivatives, glycerin alkyl ether fatty acid esters,trimethylolpropane oxyethylene alkyl ethers, fatty acid amides,alkylolamides, alkylamine oxides, lanolin and its derivatives, castoroil derivatives, hardened castor oil derivatives, sterols and itsderivatives, polyoxyethylene alkyl ethers, polyoxyethylene alkyl allylethers, polyoxyethylene alkylamine, polyoxyethylene fatty acid amides,polyoxyethylene alkylolamides, polyoxyethylene diethanolamine fatty acidesters, polyoxyethylene trimethylolpropane fatty acid esters,polyoxyethylene alkyl ether fatty acid esters, polyoxyethylenepolyoxypropylene glycols, polyoxyethylene polyoxypropylene alkyl ethers,polyoxyethylene polyoxypropylene polyhydric alcohol ethers, glycerinfatty acid esters, polyglycerin fatty acid esters, polyoxyethyleneglycerin fatty acid esters, sorbitan fatty acid esters, polyoxyethylenesorbitan fatty acid esters, sucrose fatty acid esters, or combinationsthereof.

In certain embodiments, the surface active agents comprisepolyoxyethylene glycol sorbitan alkyl esters, block copolymers ofpolyethylene glycol and polypropylene glycol, or combinations thereof.

Examples of polyoxyethylene glycol sorbitan alkyl esters are typicallythe polysorbates. Polysorbates are a class of oily liquids derived fromPEG-ylated sorbitan (a derivative of sorbitol) esterified with fattyacids. Common brand names for polysorbates include Tween®. Tween-20,Tween-60 and Tween-80, for example, are available from AkzoNobel(Strawinskylaan 2555 1077 ZZ, Amsterdam, the Netherlands). Exemplarypolysorbates include polysorbate 20 (polyoxyethylene (20) sorbitanmonolaurate), polysorbate 40 (polyoxyethylene (20) sorbitanmonopalmitate), polysorbate 60 (polyoxyethylene (20) sorbitanmonostearate), and polysorbate 80 (polyoxyethylene (20) sorbitanmonooleate).

Examples of block copolymers of polyethylene glycol and polypropyleneglycol include the poloxamers. Poloxamers are nonionic triblockcopolymers composed of a central hydrophobic chain of polyoxypropylene(poly(propylene oxide)) flanked by two hydrophilic chains ofpolyoxyethylene (poly(ethylene oxide)). Certain poloxamers, such asthose listed herein, are also known by the trade names Pluronic®available from suppliers such as BASF AG (Ludwigshafen, Germany).Because the lengths of the polymer blocks can be customized, manydifferent poloxamers exist that have slightly different properties.Further exemplary Pluronic poloxamers include, but are not limited toPluronic® 10R5, Pluronic® 17R2, Pluronic® 17R4, Pluronic® 25R2,Pluronic® 25R4, Pluronic® 31R1, Pluronic® F 108 Cast Solid Surfacta,Pluronic® F 108 NF, Pluronic® F 108 Pastille, Pluronic® F 108 Prill,Pluronic® F 108NF Prill Poloxamer 338, Pluronic® F 127, Pluronic® F 127Prill, Pluronic® F 127 NF, Pluronic® F 127 NF 500 BHT Prill, Pluronic® F127 NF Prill Poloxamer 407, Pluronic® F 38, Pluronic® F 38 Pastille,Pluronic® F 68, Pluronic® F 68 Pastille, Pluronic® F 68 LF Pastille,Pluronic® F 68 NF, Pluronic® F 68 NF Prill Poloxamer 188, Pluronic® F 68Prill, Pluronic® F 68 Prill, Pluronic® F 77, Pluronic® F 77Micropastille, Pluronic® F 87, Pluronic® F 87 NF, Pluronic® F 87 NFPrill Poloxamer 237, Pluronic® F 87 Prill, Pluronic® F 88, Pluronic® F88 Pastille, Pluronic® F 88 Prill, Pluronic® F 98, Pluronic® F 88 Prill,Pluronic® F 98, Pluronic® F 98 Prill, Pluronic® L 10, Pluronic® L 101,Pluronic® L 121, Pluronic® L 31, Pluronic® L 35, Pluronic® L 43,Pluronic® L 44, Pluronic® L 61, Pluronic® L 62, Pluronic® L 62 LF,Pluronic® L 62D, Pluronic® L 64, Pluronic® L 81, Pluronic® L 92,Pluronic® L44 NF INH surfactant Poloxamer 124, Pluronic® N 3, Pluronic®P 103, Pluronic® P 104, Pluronic® P 105, Pluronic® P 123 Surfactant,Pluronic® P 65, Pluronic® P 84, Pluronic® P 85, or combinations thereof.

In certain embodiments, the composition comprises from about 15% (wt/wt)to about 31% (wt/wt) polysorbate. In certain embodiments, saidpolysorbate is polysorbate 80. In other embodiments, the compositioncomprises from about 0.5% (wt/wt) to about 5% (wt/wt) poloxamer. Incertain embodiments, the polysorbate is polysorbate 20, polysorbate 60,polysorbate 80 or a combination thereof, and the poloxamer is Pluronic F87, Pluronic L61, Pluronic F 127, or a combination thereof. In someembodiments, the composition comprises Omega-3 fatty acid esters, suchas ethyl esters, in an amount from about 50% (wt/wt) to about 80%(wt/wt); and polysorbate from about 15% (wt/wt) to about 99% (wt/wt);and poloxamer from about 0.05% (wt/wt) to about 50% (wt/wt). In certainembodiments, the at least one surface active agent is a combination of apolysorbate, such as for example polysorbate 80, from about 15% (wt/wt)to about 31% (wt/wt) of said composition, and a poloxamer, such as forexample Pluronic F87, from about 0.5% (wt/wt) to about 5% (wt/wt) ofsaid composition.

In certain embodiments, said polysorbate comprises about 15% (wt/wt) toabout 70% (wt/wt) of said composition. In certain embodiments, saidpolysorbate comprises about 15% (wt/wt) to about 50% (wt/wt) of saidcomposition. In certain embodiments, said polysorbate comprises about15% (wt/wt) to about 31% (wt/wt) of said composition. In certainembodiments, said polysorbate comprises about 15% (wt/wt) to about 25%(wt/wt) of said composition. In certain embodiments, said polysorbatecomprises about 15% (wt/wt) to about 20% (wt/wt) of said composition. Incertain embodiments, said polysorbate comprises about 20% (wt/wt) toabout 31% (wt/wt) of said composition.

In certain embodiments, the poloxamer comprises from about 0.5% (wt/wt)to about 5% (wt/wt) of said composition. In certain embodiments, thepoloxamer comprises from about 0.5% (wt/wt) to about 4% (wt/wt) of saidcomposition. In certain embodiments, the poloxamer comprises from about0.5% (wt/wt) to about 3% (wt/wt) of said composition. In certainembodiments, the poloxamer comprises from about 0.5% (wt/wt) to about 2%(wt/wt) of said composition. In certain embodiments, the poloxamercomprises from about 0.5% (wt/wt) to about 1% (wt/wt) of saidcomposition.

In some embodiments, the compositions include one or more anionicsurface active agents. Exemplary “anionic surface active agents”include, but are not limited to, N-acyl-L-glutamic acid diethanolamine,N-acyl-L-glutamic acid triethanolamine, sodium N-acyl-L-glutamate,sodium alkanesulfonate, ammonium alkyl (C12, C14, C16) sulfate, alkyl(C11, C13, C15) sulfuric acid triethanolamine, alkyl (C11, C13, C15)sulfuric acid triethanolamine, alkyl (C12 to C14) sulfuric acidtriethanolamine, liquid alkylsulfuric acid triethanolamine, sodium alkyl(C12, C13) sulfate, liquid sodium alkylsulfate, sodium isoethionate,sodium lacto-isostearate, disodium undecylenoylamido ethylsulfosuccinate, triethanolamine sulfooleate, sodium sulfooleate,disodium oleamide sulfosuccinate, potassium oleate, sodium oleate,morpholine oleate, oleoyl sarcosine, oleoyl methyltaurine sodium salt,potassium-containing soap base, liquid base for potassium soap,potassium soap, carboxylated polyoxyethylene tridodecyl ether, sodiumsalt (3 ethyle oxide “E.O.”) of carboxylated polyoxyethylene tridodecylether, triethanolamine N-hydrogenated tallow fatty-acyl-L-glutamate,sodium N-hydrogenated tallow fatty-acyl-L-glutamate, sodium hydrogenatedcoconut fatty acid glyceryl sulfate, sodium diundecylenoylamido ethylsulfosuccinate, sodium stearyl sulfate, potassium stearate,triethanolamine stearate, sodium stearate, sodiumN-stearoyl-L-glutamate, disodium stearoyl-L-glutamate, stearoylmethyltaurine sodium salt, sodium dioctyl sulfosuccinate, liquid sodiumdioctyl sulfosuccinate, liquid disodium polyoxyethylene monooleylamidosulfosuccinate (2 E.O.), disodium polyoxyethylene lauroyl ethanolamidesulfosuccinate (5 E.O.), disodium lauryl sulfosuccinate, diethanolamidecetyl sulfate, sodium cetyl sulfate, soap base, sodium cetostearylsulfate, triethanolamine tridecyl sulfate, potassium palmitate, sodiumpalmitate, palmitoyl methyltaurine sodium salt, liquid castor oil fattyacid sodium salt (30%), ammonium polyoxyethylene alkyl ether sulfate (3E.O.), liquid diethanolamine polyoxyethylene alkyl (C12, C13) ethersulfate, liquid triethanolamine polyoxyethylene alkyl ether sulfate (3E.O.), triethanolamine polyoxyethylene alkyl (C11, C13, C15) ethersulfate (1 E.O.), triethanolamine polyoxyethylene alkyl (C12, C13) ethersulfate (3 E.O.), liquid sodium polyoxyethylene alkyl ether sulfate (3E.O.), sodium polyoxyethylene alkyl (C11, C13, C15) ether sulfate (1E.O.), sodium polyoxyethylene alkyl (C11 to C15) ether sulfate (3 E.O.),sodium polyoxyethylene alkyl (C12, C13) ether sulfate (3 E.O.), sodiumpolyoxyethylene alkyl (C12 to C14) ether sulfate (3 E.O.), sodiumpolyoxyethylene alkyl (C12 to C15) ether sulfate (3 E.O.), disodiumpolyoxyethylene alkyl (C12 to C14) sulfosuccinate (7 E.O.), sodiumpolyoxyethylene undecyl ether sulfate, liquid sodium polyoxyethyleneoctyl phenyl ether sulfate, ammonium polyoxyethylene oleyl ethersulfate, disodium polyoxyethylene lauryl sulfosuccinate, sodiumpolyoxyethylene nonyl phenyl ether sulfate, sodium polyoxyethylenepentadecyl ether sulfate, triethanolamine polyoxyethylene myristyl ethersulfate, sodium polyoxyethylene myristyl ether sulfate, sodiumpolyoxyethylene myristyl ether sulfate (3 E.O.), liquid sodiumpolyoxyethylene lauryl ether acetate (16 E.O.), ammonium polyoxyethylenelauryl ether sulfate (2 E.O.), triethanolamine polyoxyethylene laurylether sulfate, sodium polyoxyethylene lauryl ether sulfate,diethanolamine myristyl sulfate, sodium myristyl sulfate, potassiummyristyl sulfate, sodium N-myristoyl-L-glutamate, sodiummyristoylmethylaminoacetate, liquid myristoyl methyl- -alanine sodiumsalt, myristoyl methyltaurine sodium salt, medicinal soaps,triethanolamine/magnesium coco alkyl sulfate, triethanolamine N-coconutoil fatty-acyl-L-glutamate, sodium N-coconut oil fatty-acyl-L-glutamate,sodium coconut oil fatty acid ethyl ester sulfonate, coconut oil fattyacid potassium salt, liquid coconut oil fatty acid potassium salt,sodium N-coconut oil fatty/hydrogenated fatty-acyl-L-glutamate, coconutoil fatty acid sarcosine, coconut oil fatty acid sarcosinetriethanolamine salt, coconut oil fatty acid sarcosine sodium salt,coconut oil fatty acid triethanolamine salt, liquid triethanolamine saltof coconut oil fatty acid, coconut oil fatty acid sodium salt, coconutoil fatty acid methyl alanine sodium salt, liquid coconut oil fatty acidmethyl alanine sodium salt, coconut oil fatty acid methyltaurinepotassium salt, coconut oil fatty acid methyltaurine sodium salt, sodiumlaurylamino dipropionate, liquid sodium laurylamino dipropionate (30%),sodium lauryl sulfoacetate; sodium lauryl benzenesulfonate, laurylsulfate, ammonium lauryl sulate, potassium lauryl sulfate,diethanolamine lauryl sulfate, triethanolamine lauryl sulfate, sodiumlauryl sulfate, magnesium lauryl sulfate, monoethanolainine laurylsulfate, potassium laurate, lauric acid triethanolamine, liquid lauricacid triethanolamine, sodium laurate, lauric acid/myristic acidtriethanolamine, lauroyl-L-glutamic acid triethanolamine, sodiumN-lauroyl-L-glutamate, lauroyl sarcosine, lauroyl sarcosine potassium,liquid lauroyl sarcosine triethanolamine salt, lauroyl sarcosine sodium,liquid lauroyl methyl-.beta.-alanine sodium salt, lauroyl methyltaurinesodium salt, liquid lauroyl methyltaurine sodium salt, or combinationsthereof.

In certain embodiments, said anionic surfactant(s) comprise about 0.05%(wt/wt) to about 25% (wt/wt) of said composition. In certainembodiments, said anionic surfactant(s) comprise about 0.05% (wt/wt) toabout 15% (wt/wt) of said composition. In certain embodiments, saidanionic surfactant(s) comprise about 0.05% (wt/wt) to about 5% (wt/wt)of said composition. In certain embodiments, said anionic surfactant(s)comprise about 0.5% (wt/wt) to about 3% (wt/wt) of said composition. Incertain embodiments, said anionic surfactant(s) comprise about 0.7%(wt/wt) of said composition. In certain embodiments, said anionicsurfactant(s) comprise sodium lauryl sulfate.

In certain embodiments, compositions comprise an Omega-3 fatty acidester, such as an ethyl ester, and further comprise one or more surfaceactive agents. In certain embodiments, said surface active agent isselected from the group consisting of a polysorbate or a combination ofpolysorbates, and an anionic surfactant or a combination of anionicsurfactants, or a combination of said polysorbates and said anionicsurfactants. In other embodiments, the composition comprises from about15% (wt/wt) to about 31% (wt/wt) polysorbate. In certain embodiments,said polysorbate is polysorbate 80. In other embodiments, thecomposition comprises from about 0.5% (wt/wt) to about 5% (wt/wt)anionic surfactant(s). In certain embodiments, the polysorbate ispolysorbate 80, polysorbate 20, or a combination thereof, and theanionic surfactant is sodium lauryl sulfate. In some embodiments, thecomposition comprises Omega-3 fatty acid esters, such as ethyl esters,in an amount from about 40% (wt/wt) to about 85% (wt/wt); andpolysorbate from about 15% (wt/wt) to about 99% (wt/wt); and anionicsurfactant(s) from about 0.05% (wt/wt) to about 50% (wt/wt). In someembodiments, the composition comprises Omega-3 fatty acid esters, suchas ethyl esters, in an amount from about 50% (wt/wt) to about 80%(wt/wt) (90); and polysorbate from about 15% (wt/wt) to about 99%(wt/wt); and anionic surfactant(s) such as, for example, sodium laurylsulfate from about 0.05% (wt/wt) to about 2% (wt/wt). In someembodiments, the composition comprises about 0.7% (wt/wt) sodium laurylsulfate.

In certain embodiments, said poloxamer comprises about 0.05% (wt/wt) toabout 25% (wt/wt) of said composition. In certain embodiments, saidpoloxamer comprises about 0.05% (wt/wt) to about 15% (wt/wt) of saidcomposition. In certain embodiments, said poloxamer comprises about0.05% (wt/wt) to about 5% (wt/wt) of said composition. In certainembodiments, said poloxamer comprises about 0.5% (wt/wt) to about 3%(wt/wt) of said composition.

In some embodiments, the compositions include additional surface activeagents such as the zwitterionic and cationic surface active agents.Examples of such surface active agents include, but are not limited tothe bile acids (e.g., cholic acid, chenodeoxycholic acid, glycocholicacid, glycodeoxycholic acid, taurocholic acid, taurochenodeoxycholicacid, taurolithocholic acid, deoxycholic acid, lithocholic acid, andursodeoxycholic acid and salts thereof, e.g., sodium, potassium,lithium), natural emulsifiers (e.g. acacia, agar, alginic acid, sodiumalginate, tragacanth, chondrux, cholesterol, xanthan, pectin, gelatin,egg yolk, casein, wool fat, cholesterol, wax, and lecithin), long chainamino acid derivatives, high molecular weight alcohols (e.g. stearylalcohol, cetyl alcohol, oleyl alcohol, triacetin monostearate, ethyleneglycol distearate, glyceryl monostearate, and propylene glycolmonostearate, polyvinyl alcohol), carbomers (e.g. carboxy polymethylene,polyacrylic acid, acrylic acid polymer, and carboxyvinyl polymer),carrageenan, cellulosic derivatives (e.g. carboxymethylcellulose sodium,powdered cellulose, hydroxymethyl cellulose, hydroxypropyl cellulose,hydroxypropyl methylcellulose, methyl cellulose), polyoxyethylene esters(e.g. polyoxyethylene monostearate [Myrj 45], polyoxyethylenehydrogenated castor oil, polyethoxylated castor oil, polyoxymethylenestearate, and Solutol), sucrose fatty acid esters, polyethylene glycolfatty acid esters (e.g. Cremophor), polyoxyethylene ethers, (e.g.polyoxyethylene lauryl ether [Brij 30]), poly(vinyl-pyrrolidone),diethylene glycol monolaurate, triethanolamine oleate, sodium oleate,potassium oleate, ethyl oleate, oleic acid, ethyllaurate, sodium laurylsulfate, cetrimonium bromide, cetylpyridinium chloride, benzalkoniumchloride, docusate sodium or combinations thereof.

Compositions suitable for self-micellization as described hereingenerally have an HLB from about 12 to about 18. In certain embodiments,said compositions have an HLB from about 12.0 to about 14.0. In certainembodiments, said compositions have an HLB from about 13.0 to about14.0. In certain embodiments, said compositions have an HLB from about13.5 to about 13.8. The total HLB of all the surface active agents orsurfactants used in the composition is generally from about 12 to about18. In some embodiments, the total HLB of all surface active agents usedin the composition is generally from about 12 to about 15. In someembodiments, the total HLB of all surface active agents or surfactantsused in the composition is generally from about 13 to about 15.

In certain embodiments, the at least one surface active agent orsurfactant has a HLB of at least 8.0. In some embodiments, said surfaceactive agent(s) or surfactant(s) have a combined HLB in the range offrom about 13 to about 15. As the HLB value of the surface activeagent(s) or surfactant(s) increases, the amount of surface active agentor surfactant needs to be decreased, such that at an HLB of 17, onlyabout 25% (wt/wt) to about 42% (wt/wt) of surface active agent(s) orsurfactant(s) may be required.

In certain embodiments, the composition further comprises a terpene. Incertain embodiments, the terpene is d-limonene. In one embodiment, theterpene is a cyclic terpene. In one embodiment, the terpene isd-limonene ((+)-limonene), which is the (R)-enantiomer. In oneembodiment, the terpene is L-limonene, which is the (S)-enantiomer. Inone embodiment, the terpene is racemic limonene, known as dipentene. Inanother embodiment, the terpene is a terpenoid. In another embodiment,the terpene or terpenes are derived from a natural oil (e.g., a citrusoil such as orange oil). Other terpenes are contemplated, such asmonoterpenes (e.g., terpinenes, terpinolenes, phellandrenes, ormenthol), having structures that are similar to d-limonene. In certainembodiments, the compositions further comprise substantially pured-limonene from about 0.1% to about 5% by weight of the composition. Incertain other embodiments, the compositions further comprise naturalorange oil from about 0.1% to about 5% by weight of the composition.Compositions comprising d-limonene or orange oil can aid in theelimination and/or minimization of side effects from the oraladministration of Omega-3 fatty acid esters. Such side effects includeregurgitation, frequency of belching, gastroesophageal reflux disease(GERD), bloating, increased intestinal gas, fish taste, fishy breath,fish smell, nausea, diarrhea, or combinations thereof.

In other embodiments, the composition further comprises an antioxidant.In certain embodiments, the antioxidant is selected from the consistingof at least one tocopherol, at least one tocotirenol, or combinationsthereof. In other embodiments, the compositions described herein mayinclude one or more tocopherol(s). In embodiments further comprising theat least one or more antioxidant(s), the antioxidant(s) can be presentfrom about 0.01% to about 5% by weight of the compositions. In suchembodiments, the antioxidant(s) can be present at about 0.01%, 0.05%,0.1%, 0.2%, 0.3%, 0.4%, 0.5%, 0.6%, 0.7%, 0.8%, 0.9%, 1%, 1.5%, 2%,2.5%, 3%, 3.5%, 4%, 4.5% or 5% by weight of the compositions. In certainembodiments, the antioxidant(s) can be present at about 0.4% by weightof the compositions.

In an at least one additional embodiment, compositions comprisingmicelles are provided, wherein the micelles are formed by the additionof an aqueous medium to a composition of any one of the embodimentsprovided herein prior to administration of said composition to a subjectin need of treatment. Alternatively, micelles can also be formed whenthe compositions are added to an aqueous medium. In certain embodiments,the micelles have a diameter of up to about 10 μm. In other embodiments,substantially all of the micelles have an average diameter of from about1 μm to about 10 μm. In certain embodiments, the micelles have anaverage diameter of about 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 μm. In certainembodiments, said micelles are stable at room temperature. In certainembodiments, the composition forms micelles in an aqueous medium havingan acidic pH. In certain other embodiments, the compositions formmicelles in 0.1N HCl.

In another embodiment, a composition is provided, wherein saidcomposition comprises at least one(5Z,8Z,11Z,14Z,17Z)-eicosa-5,8,11,14,17-pentenoic acid (EPA) ester andat least one (4Z,7Z,10Z,13Z,16Z,19Z)-docosa-4,7,10,13,16,19-hexaenoicacid (DHA) ester, and wherein said composition has a ratio of EPA esterto DHA ester of more than 2.0:1.0 to not more than about 3.4:1.0,provided that the concentration of said EPA ester, DHA ester, or acombination thereof comprises from about 40% to about 85% by weight ofthe total amount of Omega 3 esters in said composition. In certainembodiments, the ratio of EPA ester to DHA ester is from about 2.0:1.0to about 2.5:1.0. In other embodiments, the ratio of EPA ester to DHAester is from about 2.1:1.0 to about 2.4:1.0. In other embodiments, theratio of EPA ester to DHA ester is from about 2.1:1.0 to about 2.3:1.0.In other embodiments, the ratio of EPA ester to DHA ester is from about2.1:1.0 to about 2.2:1.0. In certain embodiments, said ratio of EPAester to DHA ester in said composition is 2.4:1.0. In other embodiments,the ratio of EPA ester to DHA ester is from about 2.0:1.0 to about3.3:1.0. In other embodiments, the ratio of EPA ester to DHA ester isfrom about 2.2:1.0 to about 3.2:1.0. In other embodiments, the ratio ofEPA ester to DHA ester is from about 2.4:1.0 to about 3.1:1.0. In otherembodiments, the ratio of EPA ester to DHA ester is from about 2.5:1.0to about 3.0:1.0. In other embodiments, the ratio of EPA ester to DHAester is from about 2.6:1.0 to about 2.9:1.0. In other embodiments, theratio of EPA ester to DHA ester is from about 2.7:1.0 to about 2.8:1.0.In certain embodiments, said ratio of EPA ester to DHA ester in saidcomposition is more than 2.0:1.0.

In certain embodiments, the Omega-3 fatty acid esters used herein aresubstantially pure. In certain embodiments, the Omega-3 fatty acidesters are from about 80% to about 99% pure. In certain embodiments, theOmega-3 fatty acid esters are at least 80%, 85%, 90%, 92%, 94%, 96%, 98%or 99% pure.

Methods for Treating Cardiovascular Conditions or Disorders

Methods are provided of treating one or more cardiovascular condition ordisorder in a subject in need of treatment, which method comprisesadministering to said subject a therapeutically effective amount of acomposition of any one of the embodiments provided herein, or a micelleof any one of the embodiments provided herein.

Accordingly, in certain embodiments, the cardiovascular condition ordisorder is of the heart and vasculature, including, for example,hypertension, hyperlipidemia, hypertriglyceridemia, atherosclerosis,transient ischemic attack, systolic dysfunction, diastolic dysfunction,aneurysm, aortic dissection, myocardial ischemia, acute myocardialinfarction (AMI), acute ST-segment elevation myocardial infarction(STEMI), acute non-ST-segment elevation myocardial infarction (NSTEMI),angina pectoris, unstable angina (UA), and stable angina (SA),myocardial infarction, congestive heart failure, dilated congestivecardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy,corpulmonale, arrhythmia, valvular heart disease, endocarditis,pulmonary embolism, venous thrombosis, peripheral vascular disease, andperipheral artery disease.

In particular embodiments, the cardiovascular condition or disorder ishypertension, hyperlipidemia, or a combination thereof. In otherembodiments, the cardiovascular condition or disorder ishypertriglyceridemia.

In another embodiment, a method is provided for treating moderate tosevere hypertriglyceridemia in a subject in need thereof, wherein themethod comprises providing a subject having a fasting baseline TG levelof about 200 mg/dL to about 500 mg/dL and administering to the subject acomposition as described herein. In one embodiment, the composition canbe administered in a daily amount of from about 0.5 g to about 1 g, fromabout 1 g to about 2 g, from about 2 g to about 4 g, from about 4 g toabout 6 g, or from about 6 g to about 10 g.

In certain embodiments, the amount of total fasting TG in the subject'sblood serum is reduced by at least 20% within thirty days ofadministration of said composition or said micelles in a subject havingat least 150 mg/dL fasting blood serum TG at the start of the dosingregimen. In other embodiments, the total concentration of low-densitylipoprotein (LDL) in said subject's blood serum does not substantiallyincrease within thirty days of administration of said composition orsaid micelles. In certain embodiments, the therapeutically effectiveamount of said composition or said micelles comprises at least 0.5 g/dayof the Omega-3 fatty acid esters. In other embodiments, said subject'sblood serum has a concentration of at least 20 nmol/mL of combined EPA,DHA or combinations thereof within four hours after administration ofsaid composition or said micelles.

In further embodiments, a method is provided of administering to asubject a composition comprising at least one Omega-3 fatty acid esterwherein the ratio of high-density lipoprotein is increased relative toLDL in the blood serum of the subject. In certain embodiments, theadministration is an oral administration. In certain embodiments, thesubject is a human.

Some embodiments provide for a method of administering to a subject acomposition comprising at least one Omega-3 fatty acid ester and atleast one surface active agent, wherein said at least one Omega-3 fattyacid ester self-micellizes when in contact with an aqueous medium, andsaid at least one Omega-3 fatty acid ester when orally administered isabsorbed by said subject at a rate that is substantially independent ofa food effect. In certain embodiments, the reduction of the food effectmay yield a reduction in F of at least 30%, at least 40%, at least 50%,or at least 75%.

A method is provided of administering to a subject a compositioncomprising at least one Omega-3 fatty acid ester and at least onesurface active agent, wherein said at least one Omega-3 fatty acid esterself-micellizes when in contact with an aqueous medium, and said atleast one Omega-3 fatty acid ester when orally administered is absorbedby said subject at a rate that is substantially independent of a foodeffect. In certain embodiments, said composition is a composition of anyone of the embodiments provided herein. In other embodiments, at least0.5 g/day of the Omega-3 fatty acid ester is administered to saidsubject.

In another embodiment, the composition as described herein isadministered, for example over a period of about 1 to about 200 weeks,about 1 to about 100 weeks, about 1 to about 80 weeks, about 1 to about50 weeks, about 1 to about 40 weeks, about 1 to about 20 weeks, about 1to about 15 weeks, about 1 to about 12 weeks, about 1 to about 10 weeks,about 1 to about 5 weeks, about 1 to about 2 weeks or about 1 week. Inanother embodiment, the composition as described herein is administeredfor an unlimited period of time to a subject in need of chronictreatment.

In other embodiments, said subject's blood serum has a concentration ofat least 20 nmol/mL of said at least one Omega-3 fatty acid ester withinfour hours after administration of said composition. In otherembodiments, said subject's blood serum has a concentration of at least50 nmol/mL of said at least one Omega-3 fatty acid ester within fourhours after administration of said composition. In other embodiments,said subject's blood serum has a concentration of at least 100 nmol/mLof said at least one Omega-3 fatty acid ester within four hours afteradministration of said composition. In other embodiments, theconcentration of said at least one Omega-3 fatty acid ester in saidsubject's blood serum can be increased upon the administration ofincreasing doses of said composition.

In certain embodiments, a method is provided of minimizing and/oreliminating side effects from the oral administration of Omega-3 fattyacid esters in the presence of a surface active agent to a subject inneed of treatment comprising administering a composition of any one ofthe embodiments provided herein or the micelles of any one of theembodiments provided herein. In certain embodiments, the method ofminimizing side effects eliminates the onset of side effects. In someembodiments, non-limiting examples of the side effects includeregurgitation, frequency of belching, gastroesophageal reflux disease(GERD), bloating, increased intestinal gas, fish taste, fishy breath,fish smell, nausea, diarrhea, or combinations thereof.

In certain embodiments, a method is provided of minimizing and/oreliminating side effects from the oral administration of Omega-3 fattyacid esters in the presence of at least one terpene or natural orangeoil to a subject in need of treatment comprising administering acomposition of any one of the embodiments provided herein or themicelles of any one of the embodiments provided herein. In certainembodiments, the at least one terpene is typically, but not necessarilyd-limonene that is at least 95% pure. In certain embodiments, the methodof minimizing side effects eliminates the onset of side effects. In someembodiments, non-limiting examples of the side effects includeregurgitation, frequency of belching, gastroesophageal reflux disease(GERD), bloating, increased intestinal gas, fish taste, fishy breath,fish smell, nausea, diarrhea, or combinations thereof.

Some embodiments provide for a method of reducing a food effect in asubject in need of treatment, which method comprises administering to ahuman subject a therapeutically effective amount of any one of thecompositions described herein. In certain embodiments, the food effectis substantially eliminated.

Methods are also provided for improving patient compliance during theoral administration of Omega-3 fatty acid esters to a subject in need oftreatment comprising administering a composition as described herein.

The compositions described herein can be administered to a human subjectin need of such administration with a non-Omega-3 fatty acid esterlipid-lowering or cholesterol lowering agent selected from the groupconsisting of cholesterol absorption inhibitors, bile acidsequestrants/resins, statins, niacin and derivatives, MTP inhibitors,fibrates and CETP inhibitors. These lipid-lowering or cholesterollowering agents can be categorized by their mechanism of action. Forexample, cholesterol absorption inhibitors inhibit absorption of dietarycholesterol and inhibit reabsorption of biliary cholesterol. Examples ofcholesterol absorption inhibitors include, but are not limited to,phytosterols, ezetimibe, and(3R,4S)-1,4-bis(4-methoxyphenyl)-3-(3-phenylpropyl)-2-azetidinone (SCH48461). Bile acid sequestrants/resins are polymeric compounds andfunction as ion exchange resins. Bile acid sequestrants exchange anionssuch as chloride ions for bile acids. By doing so, they bind bile acidsand sequester them from enterohepatic circulation. Since bile acidsequesterants are large polymeric structures, they are not well-absorbedfrom the gut into the bloodstream. Thus, bile acid sequestrants, alongwith any bile acids bound to the drug, are excreted via the feces afterpassage through the gastrointestinal tract. Examples of bile acidsequestrants/resins include, but are not limited to cholestyramine,colesevelam, and colestipol. Statins are a class of compounds thatinhibit the enzyme HMG-CoA reductase. Examples of statins include, butare not limited to rosuvastatin, lovastatin, fluvastatin, simvastatin,pravastatin, and atorvastatin. It is believed that niacin and itsderivatives function by stimulating the G-protein coupled receptorGPR109A, which causes the inhibition of fat breakdown in adipose tissue.Examples of niacin and its derivatives include, but are not limited to,niceritrol, niacin, nicofuranose, aluminium nicotinate, nicotinylalcohol, and acipimox. MTP (Microsomal Triglyceride Transfer Protein) isa lipid transfer protein that is required for the assembly and secretionof very low density lipoproteins by the liver and chylomicrons by theintestine. Accordingly, inhibitors of MTP decrease levels of plasmaLDL-C. Examples of MTP inhibitors include, but are not limited to,lomitapide for human use and dirlotapide and mitrapatide for veterinaryuse in dogs. Rodent and human studies suggest that fibrates exert theirhypolipidemic effects via several mechanisms. Examples of fibratesinclude, but are not limited to bezafibrate, ciprofibrate, clofibrate,gemfibrozil, and fenofibrate. CETP (Cholesterylester Transfer Protein)inhibitors improve blood plasma lipid profiles by increasing HDL (“good”cholesterol containing particle) and decreasing LDL (“bad” cholesterolcontaining particle). Examples of CETP inhibitors include, but are notlimited to anacetrapib and evacetrapib.

In addition to the aforementioned disease states, several otherconditions or disorders can also benefit from treatment with thecompositions described herein, such as for example; metabolic syndrome;macular degeneration (AREDS2 Research Group et. al. The Age-Related EyeDisease 2 (AREDS2): study design and baseline characteristics (AREDS2report number 1), Opthalmology. 2012 Nov. 119(11):2282-9. doi10.1016/j.optha 2012.05.027. Epub 2012 Jul. 26; SanGiovanni J P et. al.,ω-3 long-chain polyunsaturated fatty acid intake and 12-y incidence ofneovascular age-related macular degeneration and central geographicatrophy: AREDS report 30, a prospective cohort study from theAge-Related Eye Disease Study. Am. J. Clin. Nutr. 2009; 90:1601-70.);cognitive impairment resulting from surgery or traumatic brain injury,such as for example resulting from a concussion (Lewis M. et. al.Therapeutic use of omega-3 fatty acids in severe head trauma. Am J EmergMed. 2013 January; 31(1):273.e5-8. doi: 10.1016/j.ajem.2012.05.014. Epub2012 Aug. 3; Mills J D. et. al. Dietary supplementation with the omega-3fatty acid docosahexaenoic acid in traumatic brain injury. Neurosurgery.2011 February; 68(2):474-81; discussion 481. doi:10.1227/NEU.0b013e3181ff692b.); major depression, suicide, post-partumdepression (Logan A C. Omega-3 fatty acids and major depression: aprimer for the mental health professional. Lipids Health Dis. 2004 Nov.9; 3:25; Lewis M D et al. Suicide deaths of active-duty US military andomega-3 fatty-acid status: a case-control comparison. J Clin Psychiatry.2011 December; 72(12):1585-90. doi: 10.4088/JCP.11m06879. Epub 2011 Aug.23; Makrides M. et. al. Docosahexaenoic acid and post-partumdepression—is there a link? Asia Pac J Clin Nutr. 2003; 12 Suppl:S37.);inflammation (Kelley D S et. al. DHA supplementation decreases serumC-reactive protein and other markers of inflammation inhypertriglyceridemic men. J Nutr. 2009 March; 139(3):495-501. doi:10.3945/jn.108.100354. Epub 2009 Jan. 21.); primary sclerosingcholangitis (Martin C R. et. al. The safety and efficacy of oraldocosahexaenoic acid supplementation for the treatment of primarysclerosing cholangitis—a pilot study. Aliment Pharmacol Ther. 2012January; 35(2):255-65. doi: 10.1111/j.1365-2036.2011.04926.x. Epub 2011Nov. 30.), borderline personality disorder in women (Zanarini M C et al.Omega-3 Fatty acid treatment of women with borderline personalitydisorder: a double-blind, placebo-controlled pilot study. Am JPsychiatry. 2003 January; 160(1):167-9.), breast cancer (Bougnoux P. etal. Improving outcome of chemotherapy of metastatic breast cancer bydocosahexaenoic acid: a phase II trial. Br J Cancer. 2009 Dec. 15;101(12):1978-85. doi: 10.1038/sj.bjc.6605441. Epub 2009 Nov. 17.),non-alcoholic fatty acid liver disease (Parker H M. et. al. Omega-3supplementation and non-alcoholic fatty liver disease: a systematicreview and meta-analysis. J Hepatol. 2012 April; 56(4):944-51. doi:10.1016/j.jhep.2011.08.018. Epub 2011 Oct. 21; Nobili V. Docosahexaenoicacid for the treatment of fatty liver: Randomised controlled trial inchildren. Nutr Metab Cardiovasc Dis. 2012 Dec. 7. pii:S0939-4753(12)00256-6. doi: 10.1016/j.numecd.2012.10.010. [Epub ahead ofprint]; Christopher M. D. et. al. Menhaden oil decreases high-fatdiet-induced markers of hepatic damage, steatosis, inflammation, andfibrosis in obese Ldlr−/− mice. J Nutr. 2012 August; 142(8):1495-503.doi: 10.3945/jn.112.158865. Epub 2012 Jun. 27.), and improvement incognition and behavior in children (Richardson A J. et. al.Docosahexaenoic acid for reading, cognition and behavior in childrenaged 7-9 years: a randomized, controlled trial (the DOLAB Study). PLoSOne. 2012; 7(9):e43909. doi: 10.1371/journal.pone.0043909. Epub 2012Sep. 6.). These conditions or disorders can be treated by administeringthe compositions described herein to a subject, typically a human, inneed of such administration.

Kits

Packaged pharmaceutical kits are included herein. The kits comprisecompositions described herein as unit dosage forms in a container andinstructions for using the dosage form to treat a subject having adisease or disorder responsive to treatment by administration of thedosage forms comprising the compositions described herein.

The packaged pharmaceutical kits provide prescribing information, overthe counter medical use information, and/or nutritional information forthe dosage form including, for example and without limitation, to asubject or health care provider, or as a label in a packagedpharmaceutical kit. Information included in the kit may include, forexample and without limitation, efficacy, dosage and administration,contraindication and adverse reaction information pertaining to theOmega-3 fatty acid dosage form. The dosage and administrationinformation, for example, can include dosing frequency as well asadministration of the compositions with or without food.

In certain embodiments the dosage forms comprising the compositionsprovided herein are in the form of liquid or capsules provided either asblister packages or in bottles together with over the counter medicaluse information and/or nutritional information.

The packaged pharmaceutical kits can comprise one or more of thecompositions described herein as the only active ingredient. In otherembodiments, one or more of the compositions described herein can bepackaged in combination with one or more active agents other than anon-Omega 3 ester, such as for example and without limitation, one ormore other lipid lowering or cholesterol lowering agents selected fromthe group consisting of cholesterol absorption inhibitors, bile acidsequestrants/resins, statins, niacin and derivatives, MTP inhibitors,fibrates and CETP inhibitors.

Dosage Forms

Any of the compositions provided herein comprising at least one Omega-3fatty acid ester can be provided as a pharmaceutical composition, anutraceutical formulation, or a dietary supplement.

The pharmaceutical compositions described herein may further include oneor more pharmaceutically acceptable excipients. Pharmaceuticallyacceptable excipients include, but are not limited to, carriers,preservatives, and/or coloring agents. General considerations in thecomposition and/or manufacture of pharmaceutical compositions may befound, for example, in Remington The Science and Practice of Pharmacy21st ed., Lippincott Williams & Wilkins, 2005.

In certain embodiments, the compositions described herein can beformulated as a liquid for oral administration. Liquid compositionsinclude solutions, suspensions and emulsions. Examples of liquidpharmaceutical preparations include propylene glycol solutions andsolutions containing sweeteners for oral solutions, suspensions andemulsions. When the liquid composition comes into contact with anaqueous medium, such as for example an aqueous medium having an acidicenvironment, the composition forms micelles.

In certain embodiments, the dosage form comprises micelles pre-formedprior to administration to a subject in need of such administration.Such pre-formed micelles are stable at room temperature.

In other embodiments, the compositions described herein can beformulated as a fill material for a soft gelatin capsule. Likewise, whenthe contents of the soft gelatin capsule comes into contact with anaqueous medium, the composition forms micelles upon disintegration ofthe capsule.

A capsule may be prepared, e.g., by placing the compositions describedabove inside a capsule shell. A capsule is a dosage form administered ina special container or enclosure containing an active agent. In someembodiments the compositions described herein can be filled into softcapsules. A capsule shell may be made of methylcellulose,hydroxypropylmethyl cellulose, polyvinyl alcohols, or denatured gelatinsor starch or other material. Hard shell capsules are typically made ofblends of relatively high gel strength bone and pork skin gelatins. Insome embodiments the unit dosage form is a gel capsule. In someembodiments the capsule shell is a glycerin capsule shell, for exampleproduct no. GSU0051 manufactured by SwissCaps and which meets USP 25requirements (SwissCaps, USA 14193 SW 119th Ave., Miami/Fla., U.S.33186). In other embodiments the capsule is a bovine gelatin shell, forexample SwissCaps product no. GSU0708. Other suitable capsule shellmaterials include polyethylene, polypropylene, poly(methylmethacrylate),polyvinylchloride, polystyrene, polyurethanes, polytetrafluoroethylene,nylons, polyformaldehydes, polyesters, cellulose acetate, andnitrocellulose. The capsule shell itself may contain small amounts ofdyes, opaquing agents, plasticizers, and preservatives. Conventionalmethods for preparing other solid dosage forms, for example, capsules,suppositories, and the like are also well known. Gelatin capsule shellsmay be made also be made of tapioca, grass, vegetable derived or fishderived gelatin. For example K-CAPS (Capsuline, Inc. Pompano Beach,Fla.) is a certified Kosher soft capsule shell of vegetable origin.Other vegetarian derived gelatin capsules may, be made of vegetablederived hydroxypropylmethyl cellulose (HPMC). Capsules shells may alsocontain Modified Maize Starch, Glycerol, and Carrageenan as a gellingagent.

In other embodiments the capsule has a shell comprising the material ofthe rate-limiting membrane, including coating materials, and filled withthe compositions described herein. Capsule shells may be made of aporous or a pH-sensitive polymer made by a thermal forming process. Incertain embodiments the capsule shell in the form of an asymmetricmembrane; i.e., a membrane that has a thin skin on one surface and mostof whose thickness is constituted of a highly permeable porous material.

Yet another useful capsule, a “swelling plug device”, can be used. Thecompositions described herein can be incorporated into a non-dissolvingcapsule-half of the device which is sealed at one end by a hydrogelplug. This hydrogel plug swells in an aqueous environment, and, afterswelling for a predetermined time, exits the capsule thus opening a portthrough which the active agent can leave the capsule and be delivered tothe aqueous environment. Preferred hydrogel-plugged capsules are thosewhich exhibit substantially no release of active agent from the dosageform until the dosage form has exited the stomach and has resided in thesmall intestine for about 15 minutes or more, preferably about 30minutes or more, thus assuring that minimal Omega-3 fatty acid ester isreleased in the stomach or the small intestine. Hydrogel-pluggedcapsules of this type have been described in patent applicationWO90/19168.

The dosage forms may contain a plasticizer, particularly in a capsuleshell. Suitable plasticizers include, e.g., polyethylene glycols such asPEG 300, PEG 400, PEG 600, PEG 1450, PEG 3350, and PEG 800, stearicacid, propylene glycol, oleic acid, triethyl cellulose, triacetin,glycerin, sorbitol, sorbitan or combinations thereof.

In additional embodiments, the compositions can be formulated as aliquid for parenteral administration.

Compositions can be formulated as one or more dosage units. In someembodiments, it can be advantageous to formulate oral compositions indosage unit form for ease of administration and uniformity of dosage.Dosage unit forms described in some embodiments can refer to physicallydiscrete units suited as unitary dosages for the subject to be treated;each unit containing a predetermined quantity of active compositioncalculated to produce the desired therapeutic effect in association withthe suitable pharmaceutical carrier. In certain embodiments, the dosageform may optionally contain a flavorant such as orange oil,substantially pure d-limonene, and an antioxidant such as tocopherol,ascorbyl palmitate or a combination of antioxidants.

Functional Foods

In certain embodiments, the compositions described herein comprisemicelles pre-formed prior to administration to a subject in need of suchadministration. Such pre-formed micelles are stable at room temperature.

Accordingly, either such pre-formed micelles or the pre-micellizedcompositions described herein can be added to foods, which can then beconsumed as part of a healthy diet for enriching a subject's Omega-3fatty acid levels or as a dietary treatment in addition to theoral/parenteral administration of the compositions described herein asprescribed by a health professional.

In certain embodiments, the functional food is in the form of edible ordrinkable compositions, e.g., foodstuffs such as chewable or ediblebars, confectionary products (e.g., chocolate bars), cookies, juicedrinks, baked or simulated baked goods (e.g., brownies), biscuits,lozenges or chewing gum. Examples of chewable or edible bars includechocolate bars or energy bars. Such functional foods can be particularlyuseful to people participating in sports or other forms of exercise.

In certain embodiments, the functional foods may also be in the form of,for example, butter, margarine, bread, cake, milk shakes, ice cream,yogurt and other fermented milk product.

In certain embodiments, the functional food can also be in the form of aliquid to be sprayed on meats, salads or other foods.

Other forms of the functional foods can be breakfast cereals, such asfor example, grain flakes, muesli, bran, oatmeal.

When the functional food product is in a drinkable form, thecompositions described herein can be added directly to the drink, suchas for example plain milk, flavored milk, fermented milk products orjuices. The compositions will form micelles comprising the Omega-3 fattyacid esters in the drinkable product.

When the functional food is in the form of a solid edible product, thecompositions described herein can be first added to an aqueous medium,wherein the composition will form micelles as described herein. Theaqueous medium comprising the micelles can subsequently be eithersprayed onto the solid edible product or mixed into the ingredients whenmanufacturing the edible product.

The invention is further defined by reference to the following examples,which are not meant to limit the scope of the present invention. It willbe apparent to those skilled in the art that many modifications, both tothe materials and methods, may be practiced without departing from thepurpose and interest of the invention.

Non-Limiting Working Examples

Example 1

The amounts and percentages of the ingredients comprising thecomposition are shown in Table 1:

TABLE 1 COMPOSITION (FILL MASS)/dosage form INGREDIENT Amount (mg) %(wt/wt) Total Omega-3 fatty acid 754.3 68.57 Ethyl Esters EPA EthylEsters 392.2 35.65 DHA Ethyl Esters 165.9 15.08 Polysorbate 80 337.930.72 Pluronic F87 7.8 0.71 GEL MASS/dosage form INGREDIENT Amount (gm)% (wt/wt) Gelatin 270 40 Glycerin 135 20 Purified water 270 40

The manufacturing process for the dosage form comprising one embodimentof the composition can be separated into three stages: a) the processfor manufacturing the composition (fill mass), b) the process formanufacturing the gel mass used for encapsulating the fill mass, and c)the encapsulation process. Stages (a) and (b) can be carried out ineither order.

The process for manufacturing the composition begins by weighingappropriate amounts of the Polysorbate 80 and Pluronic F87 as per thedesired batch size and mixing them to homogeneity at 60° C. in astainless steel tank. This mixture is allowed to cool to roomtemperature before the substantially pure Omega-3 fatty acid ethyl estermixture is vacuum-transferred quantitatively into the same stainlesssteel tank containing the Polysorbate 80 and Pluronic F87. This mixtureis again mixed to homogeneity at room temperature before being blanketedwith nitrogen. This final composition is also termed the “fill mass”.

The process for manufacturing the gel mass begins by weighingappropriate amounts of each of the glycerin and water as per the desiredbatch size and mixing them to homogeneity in a separate stainless steelmixer at about 80° C. Next, the appropriate amount of gelatin is weighedas per the batch size, added to the glycerin/water mixture and againmixed to homogeneity at 80° C. before being degassed under vacuum. Thisfinal mixture comprising glycerin/water/gelatin is termed the “gelmass”.

Depending on the desired shape of the capsule, suitable dies andtransfer tubing are installed into a soft gel encapsulation apparatus(SS-60 Softgel Encapsulation Machine by SKY Softgel Co. Ltd., Incheon,Korea). The fill mass is pumped into the dies containing a pre-formedribbon comprising the semi-solid gel mass. The dies shape the softgelatin capsules, which are then tumble dried for about 20-60 min. Thecapsules are transferred onto a tray and dried in alow-temperature/humidity drying room and dried until the capsules reachabove 75 shore hardness. The capsules are then inspected, sorted,polished, printed and packaged into bottles. The bottles are affixedwith a label, which includes prescribing information. Alternatively, thebottles can be packaged into boxes with a package insert, which includesprescribing information.

Example 2

Experiments were conducted to determine micelle formation in twocompositions, A and B, as shown in Table 2. Both compositions wereprepared as described in Example 1 comprising Omega-3 fatty acid ethylesters, in which the Omega-3 fatty acid ethyl esters had increasedabsorption and the food effect was substantially eliminated.

TABLE 2 % (wt/wt) Ingredients Composition A Composition B Omega-3 fattyacid Ethyl Esters 68.57 75.0 Polysorbate 80, NF 30.71 20.0 Pluronic F870.71 5.0 Combined surfactant HLB 15.3 16.8 Whole Product HLB 13 13.2

The compositions which formed well dispersed micelles generally had acombined surfactant HLB value of about 15 to about 17.

Other compositions with Polysorbate 80 levels between 27-29% incombination with Pluronic F87 between about 7% to about 22% generallyformed large oil globules. These compositions had a combined surfactantHLB value of from about 17 to about 19. Based on these experiments thewhole product HLB was from about 13 and about 14.4 and the combinedsurfactant HLB was between about 12 to about 17.

Example 3

Compositions A and B (1,000 mg), as shown in Table 2, were added toseparate containers containing 500-900 mL of water in 0.1N HCl, underUnited States Pharmacopeia (USP) dissolution 2 conditions, as describedin General Chapter 711, United States Pharmacopeia, 34/National/2011,and observed. Neither composition was subjected to any agitation orshearing. When observed under the microscope, very small, well dispersedmicelles were visible. The micelles were stable for over twelve monthsat room temperature and there was no apparent separation of the Omega-3fatty acid esters from the other ingredients of the composition. Thus,compositions that included Polysorbate 80 levels between 20-31% incombination with Pluronic F87 at 0.7 to 5% formed stable micelles.

Example 4

A human subject ingested composition A in Example 2 (the “ExperimentalComposition”) and underwent blood monitoring to measure the increase inabsorption of the Omega-3 fatty acid ethyl esters compared to theOmega-3 fatty acid ethyl esters in an Omega-3 fatty acid ethyl estercomposition that is representative of currently marketed drug andnutritional Omega-3 products (the “Standard Composition”). The StandardComposition was manufactured by encapsulating Omega-3 ethyl esters usingstandard encapsulating methods. Absorption of Omega-3 fatty acid ethylesters was determined by comparing changes in subject's OmegaIndexfollowing ingestion of the compositions, as measured using theOmegaIndex test kit by OmegaQuant. Prior to ingestion of a composition,blood was drawn from the subject to determine subject's baselineOmegaIndex. The subject then ingested soft gel capsules containingeither the Experimental Composition or the Standard Composition. Asubsequent blood draw occurred at four hours post-ingestion. The subjectremained in the fasted state from the initial baseline blood drawthrough the four-hour blood draw. The results are shown in Table 4.

TABLE 4 Dose EPA + DHA Ethyl Omega Index Capsule Composition EstersInitial 4 hour Increase Standard Composition 1.52 g 5.2 5.3 1.92%Experimental Composition 1.46 g 5.4 5.7 5.55% Dose A (4 capsules, 400 mgtotal fill weight per capsule) Experimental Composition 3.65 g 4.9 5.38.16% Dose B (10 capsules, 400 mg total fill weight per capsule)

Example 5

An Open-label, Randomized, 3 arm, Parallel group, Proof of Concept Studywas conducted to evaluate the serum TG lowering efficacy and safety ofSC401 Capsules 1100 mg (manufactured as described in Example 1) vs.LOVAZA® (Omega-3-acid ethyl esters) Capsules 1000 mg vs. PLACEBO inhypertriglyceridemic subjects with serum TG between 250 and 500 mg/dLwhen dosed under fasting conditions.

The aim of this study was to evaluate the effectiveness of SC401 vs.LOVAZA® vs. Placebo on TG reduction over 14 days of treatment. 45subjects were enrolled in the study in order to complete at least 12subjects in each of the three treatment arms.

The following inclusion and exclusion criteria were used to select thesubjects for this study:

Inclusion Criteria:

-   -   Men and women 18 years of age or older;    -   Serum TG between 200 and 500 mg/dL.    -   Normally active and in good health on the basis of medical        history, brief physical examination, electrocardiogram, and        routine laboratory tests.    -   Be neither over weight nor under weight for his/her height as        per the attached height/weight table values (see attached        height/weight table).    -   Provide written informed consent.    -   If female and of child bearing potential; is practicing an        acceptable method of birth control for the duration of the study        as judged by the investigator (s), such as condoms, foams,        jellies, diaphragm, intrauterine device (IUD), or abstinence; or        is postmenopausal for at least 1 year; or is surgically sterile        (bilateral tubal ligation, bilateral oophorectomy, or        hysterectomy).

Exclusion Criteria:

-   -   Severe hypertriglyceridemia (serum TG >500 mg/dL).    -   Intolerance to Omega-3 or fish.    -   Use of Omega-3 fish oil, other EPA or DHA and/or DHA fortified        foods or other TG lowering medications within three months of        study drug initial administration, or during the study.    -   Consumption of any fish within seven days of study drug initial        administration or during the study.    -   Recent history of certain heart, kidney, liver, lung, or        gastrointestinal diseases or cancer (except non-melanoma skin        cancer).    -   Diabetes or receiving insulin therapy.    -   Pregnant or lactating females. Women of childbearing potential        who are not using a medically approved method of contraception.    -   Use of certain types of hormones, anticonvulsant drugs,        immunologic drugs, antibiotic, antifungal and antiviral drugs,        and cardiac drugs.    -   Use of warfarin (Coumadin).    -   Recent history (past 12 month) of drug abuse or alcohol abuse.    -   Exposure to any investigational product, within 28 days prior to        study drug administration.    -   Subjects diagnosed with the following conditions:    -   Endocrine diabetes mellitus, hypothyroidism, pregnancy;    -   Nutritional obesity, alcohol access;    -   Renal nephrotic disease, chronic renal failure;    -   Hepatic disease cholestas, hepatocellular dysfunction;    -   Immunoglobulin excess paraproteinemia;    -   Gout;    -   Any other condition the investigator believes would interfere        with the patient's ability to provide informed consent, comply        with study instructions, or which might confound the        interpretation of the study results or put the patient at undue        risk; and subjects on the following medications Thiazide        diuretic, Steroid hormones, Microsomal enzyme, Retinoic acid        derivatives, Protease inhibitors (HIV infection).

The Informed Consent Document (ICD) was read by the volunteer and signedprior to study specific procedures. Additionally, the following testswere be performed at clinic entry for each period

-   -   Urine screen for drugs of abuse—including cocaine, cannabis,        amphetamines, barbiturates, benzodiazepines and opiates.        Subjects were rejected/withdrawn from the study if the result        was positive for these drugs,    -   Alcohol breath test—subjects were rejected/withdrawn from the        study if the result was positive for alcohol,    -   Urine pregnancy test (HCG) (for female subjects only)—Female        subjects were rejected/withdrawn from the study if result was        positive for pregnancy, and    -   Gynecological & breast examination (for female subjects        only)—subjects were rejected/withdrawn from the study if there        were any abnormalities in the examination.

Subjects were housed in the clinical facility from at least 48 hourspre-dose to at least 14 days and were requested to stay for 16consecutive nights in the facility.

Subjects were fasted for at least 10 hours before morning dosing andwere instructed to abstain from consuming caffeine and/or xanthinecontaining products (i.e. coffee, tea, chocolate, andcaffeine-containing sodas, colas, etc.), alcohol and vitaminsupplements, including vitamin C and ascorbic acid and grapefruit andits juice, for at least 48 hours prior to dosing and throughout thestudy. No citrus juices, including orange juice and grapefruit juice,were provided during the study.

After overnight fast of 10 hours subjects were dosed under monochromaticlight or low light condition as follows:

SC401 (Omega-3 Fatty Acid Ethyl Esters, 1100 mg) 2 capsules (as singledose), taken upon awakening (at least 2 hours before breakfast takenwith water only on an empty stomach); then 2 capsules (as single dose)taken at bedtime (at least 2 hours after dinner taken with water onlyand no food or liquids thereafter for the night), or

LOVAZA® (Omega-3 Fatty Acid Ethyl Esters, 1000 mg, of GlaxoSmithKline,RTP, NC 2770) 2 capsules (as single dose) taken upon awakening (at least2 hour before breakfast taken with water only on an empty stomach); then2 capsules (as single dose) taken at bedtime (at least 2 hours afterdinner taken with water only and no food or liquids thereafter for thenight), or

PLACEBO (Ethyl Oleate, 1000 mg capsules) 2 capsules (as single dose)taken upon awakening (at least 2 hour before breakfast taken with wateronly on an empty stomach); then 2 capsules (as single dose) taken atbedtime (at least 2 hours after dinner taken with water only and no foodor liquids thereafter for the night).

The amounts of Omega-3 fatty acid ethyl esters comprising Lovaza, SC401and the placebo are shown in the Table 5 below:

TABLE 5 Capsule Fill Composition (mg) SC401 Lovaza ® Placebo TotalOmega-3 Fatty Acid 754.3 934 0 Ethyl Esters EPA Ethyl Esters 392.2 482 0DHA Ethyl Esters 165.9 370 0 Polysorbate 80, NF 337.9 0 0 Pluronic F877.8 0 0 Ethyl Oleate 0 0 1000

4 blood samples (8 mL each) were collected over the study period. Theblood samples will be collected at T_(s), T₀, T_(7d), T_(14d) in plainvacuum tubes by direct vein puncture. Vacutainers were placed upright ina rack kept in wet ice bath until transferred to Diagnostic department.

For T_(s), T₀, T_(7d), T_(14d), fasting triglyceride/HDL/LDL/totalcholesterol/non-HDL/levels for each patient in each of three groups wasdetermined.

The data are tabulated in Table 6 below:

TABLE 6 Results at Day 14 from Baseline* SC401 Lovaza ® Placebo Serumblood levels of −48.5% −29.4% −27.7% triglycerides *SC401 resultsadjusted to match amount of total EPA and DHA ethyl esters dosed inLovaza ® arm.

That which is claimed:
 1. A composition which forms stable micelles uponcontact with an aqueous medium, said composition comprising: a. fromabout 40% (wt/wt)—about 95% (wt/wt) of at least one omega-3 fatty acidester or a derivative thereof, selected from the group consisting of(all-Z omega-3)-5,8,11,14,17-eicosapentaenoic acids (EPA) ester, (all-Zomega-3)-4,7,10,13,16,19-docosahexaenoic acids (DHA) ester,hexadecatrienoic acid (“HTA” or 16:3 (n-3), orall-Z-7,10,13-hexadecatrienoic acid), α-linolenic acid (“ALA” or 18:3(n-3), or all-Z-9,12,15-octadecatrienoic acid), stearidonic acid (“SDA”or 18:4 (n-3) or all-Z-6,9,12,15-octadecatetraenoic acid),eicosatrienoic acid (“ETE” or 20:3 (n-3) or all-Z-11,14,17eicosatrienoic acid), eicosatetraenoic acid (“ETA” or 20:4 (n-3),heneicosapentaenoic acid (“HPA” or 21:5 (n-3) orall-Z-6,9,12,15,18-heneicosapentaenoic acid), docosapentenoic acid(“DPA”, or clupanodonic acid or 22:5 (n-3) orall-Z-7,10,13,16,19-docosapentenoic acid), tetracosapentenoic acid (24:5(n-3) or all-Z-9,12,15,18,21-tetracosapentenoic acid), andtetracosahexaenoic acid (nisinic acid or 24:6 (n-3) andall-Z-6,9,12,15,18,21-tetracosahexaenoic acid; b. a surface active agentwhich comprises, in combination, at least one non-ionic polyoxyethyleneglycol sorbitan alkyl ester (a polysorbate) selected from the groupconsisting of polyoxyethylene (20) sorbitan monolaurate (polysorbate20), polyoxyethylene (20) sorbitan monopalmitate (polysorbate 40),(polyoxyethylene (20) sorbitan monostearate (polysorbate 60) andpolyoxyethylene (20) sorbitan monooleate (polysorbate 80); and a blockcopolymer of polyethylene glycol and polypropylene glycol having theformula [(HO(C₂H₄O)₆₄ (C₃H₆O)₃₇ (C₂H₄O)₆₄H] (Poloxamer 237); whereinsaid polysorbate is present in an amount within the range of about 15%(wt/wt) to about 99% (wt/wt) of said composition; and said Poloxamer 237is present in an amount within the range of about 0.05% (wt/wt) to about50% (wt/wt) of said composition; whereby said combination of surfaceactive agents are effective to form said stable micelles upon contactwith said aqueous medium.
 2. The composition according to claim 1wherein said at least one fatty acid ester is an ethyl ester.
 3. Thecomposition according to claim 1, comprising a mixture of EPA fatty acidester or derivatives thereof and DHA fatty acid ester or derivativesthereof; wherein the ratio of said EPA fatty acid ester or derivativesthereof: DHA fatty acid ester or derivatives thereof is a ratio (wt/wt)within the range of about 1.0:2.0 to about 3.4:1.0; and wherein said EPAfatty acid ester or derivatives thereof and DHA fatty acid ester orderivatives thereof constitute from about 40% to about 95% (wt/wt) ofthe total Omega-3 fatty acid esters in the composition.
 4. Thecomposition according to claim 1, wherein said polysorbate is present inan amount within the range of about 15% (wt/wt) to about 50% (wt/wt) ofsaid composition.
 5. The composition according to claim 1, wherein saidpolysorbate is present in an amount within the range of about 15%(wt/wt) to about 31% (wt/wt) of said composition.
 6. The compositionaccording to claim 1, wherein said polysorbate is present in an amountwithin the range of about 15% (wt/wt) to about 25% (wt/wt) of saidcomposition.
 7. The composition according to claim 1, wherein saidpolysorbate is present in an amount within the range of about 15%(wt/wt) to about 20% (wt/wt) of said composition.
 8. The compositionaccording to claim 1, wherein said polysorbate is present in an amountwithin the range of about 20% (wt/wt) to about 31% (wt/wt) of saidcomposition.
 9. The composition according to claim 1, wherein saidPoloxamer 237 is present in an amount within the range of about 0.05%(wt/wt) to about 5% (wt/wt) of said composition.
 10. The compositionaccording to claim 1, wherein said Poloxamer 237 is present in an amountwithin the range of about 0.05% (wt/wt) to about 4% (wt/wt) of saidcomposition.
 11. The composition according to claim 1, wherein saidPoloxamer 237 is present in an amount within the range of about 0.05%(wt/wt) to about 3% (wt/wt) of said composition.
 12. The compositionaccording to claim 1, wherein said Poloxamer 237 is present in an amountwithin the range of about 0.05% (wt/wt) to about 2% (wt/wt) of saidcomposition.
 13. The composition according to claim 1, wherein saidPoloxamer 237 is present in an amount within the range of about 0.05%(wt/wt) to about 1% (wt/wt) of said composition.
 14. The compositionaccording to claim 1, wherein the ratio of EPA fatty acid ester orderivatives thereof to DHA fatty acid ester or derivatives thereof is aratio (wt/wt) within the range of about 1.0:2.0 to about 2.0:1.0. 15.The composition according to claim 1, wherein the ratio of EPA fattyacid ester or derivatives thereof to DHA fatty acid ester or derivativesthereof is a ratio (wt/wt) within the range of more than 2.0:1.0 to notmore than 3.4:1.0.
 16. The composition according to claim 1, wherein theratio of EPA fatty acid ester or derivatives thereof to DHA fatty acidester or derivatives thereof is a ratio (wt/wt) within the range ofabout 2.0:1.0 to about 3.0:1.0.
 17. The composition according to claim1, wherein the ratio of EPA fatty acid ester or derivatives thereof toDHA fatty acid ester or derivatives thereof is a ratio (wt/wt) withinthe range of about 2.0:1.0 to about 2.7:1.0.
 18. The compositionaccording to claim 1, wherein the ratio of EPA fatty acid ester orderivatives thereof to DHA fatty acid ester or derivatives thereof is aratio (wt/wt) within the range of about 2.0:1.0 to about 2.5:1.0. 19.The composition according to claim 1, wherein the ratio of EPA fattyacid ester or derivatives thereof to DHA fatty acid ester or derivativesthereof is a ratio (wt/wt) within the range of about 2.0:1.0 to about2.4:1.0.
 20. The composition according to claim 1, wherein the ratio ofEPA fatty acid ester or derivatives thereof to DHA fatty acid ester orderivatives thereof is a ratio (wt/wt) within the range of about 2.1:1.0to about 2.3:1.0.
 21. The composition according to claim 1, wherein theratio of EPA fatty acid ester or derivatives thereof to DHA fatty acidester or derivatives thereof is a ratio (wt/wt) within the range ofabout 2.1:1.0 to about 2.2:1.0.
 22. The composition according to claim1, wherein the ratio of EPA fatty acid ester or derivatives thereof toDHA fatty acid ester or derivatives thereof is a ratio (wt/wt) withinthe range of about 2.4:1.0 to about 3.1:1.0.
 23. The compositionaccording to claim 1, wherein the ratio of EPA fatty acid ester orderivatives thereof to DHA fatty acid ester or derivatives thereof is aratio (wt/wt) within the range of about 2.5:1.0 to about 3.0:1.0. 24.The composition according to claim 1, wherein the ratio of EPA fattyacid ester or derivatives thereof to DHA fatty acid ester or derivativesthereof is a ratio (wt/wt) within the range of about 2.6:1.0 to about2.9:1.0.
 25. The composition according to claim 1, wherein the ratio ofEPA fatty acid ester or derivatives thereof to DHA fatty acid ester orderivatives thereof is a ratio (wt/wt) within the range of about 2.7:1.0to about 2.8:1.0.
 26. The composition according to claim 1, wherein theOmega-3 fatty acid ester is an EPA fatty acid ester or derivativethereof, a DHA fatty acid ester or derivative thereof, or a combinationthereof, and each of said EPA fatty acid ester or derivative thereof orDHA fatty acid ester or derivative thereof is from about 80% to about99% pure.
 27. The composition according to claim 1, wherein thecomposition further comprises a terpene.
 28. The composition accordingto claim 1, further comprising from about 0.1% (wt/wt) to about 5%(wt/wt) of said composition of a substantially pure d-limonene.
 29. Thecomposition according to claim 1, further comprising from about 0.1%(wt/wt) to about 5% (wt/wt) of said composition of natural orange oil.30. The composition according to claim 1, further comprising at leastone antioxidant.
 31. The composition according to claim 30, wherein saidat least one antioxidant is selected from the group consisting oftocopherol, tocotrienol, or a combination thereof.
 32. The compositionaccording to claim 1, wherein said polysorbate is polysorbate
 80. 33.The composition according to claim 1, wherein said at least one omega-3fatty acid ester is (all-Z omega-3)-5,8,11,14,17-eicosapentaenoic acids(EPA) ester or a derivative thereof, which is from about 80% to about99% pure.
 34. The composition according to claim 1, wherein said atleast one omega-3 fatty acid ester is (all-Zomega-3)-4,7,10,13,16,19-docosahexaenoic acids (DHA) ester or aderivative thereof, which is from about 80% to about 99% pure.
 35. Thecomposition according to claim 1, further including at least onelipid-lowering agent selected from the group consisting of cholesterolabsorption inhibitors, bile acid sequestrants/resins, statins, niacinand derivatives, microsomal triglyceride transfer protein (MTP)inhibitors, fibrates and cholesteryl ester transfer protein (CETP)inhibitors.
 36. The composition according to claim 1, wherein saidsurface active agent contains a polysorbate at a concentration ofbetween about 20% (wt/wt) to about 31% (wt/wt) of said composition, incombination with Poloxamer 237 at a concentration of about 0.7% (wt/wt)to about 5% (wt/wt) of said composition.
 37. The composition accordingto claim 36, wherein said polysorbate is polysorbate
 80. 38. Thecomposition according to claim 1, wherein said stable micelles have anaverage diameter of about 1 μm to about 10 μm.
 39. A surface activeagent which comprises, in combination, at least one non-ionicpolyoxyethylene glycol sorbitan alkyl ester (a polysorbate) selectedfrom the group consisting of polyoxyethylene (20) sorbitan monolaurate(polysorbate 20), polyoxyethylene (20) sorbitan monopalmitate(polysorbate 40), (polyoxyethylene (20) sorbitan monostearate(polysorbate 60) and polyoxyethylene (20) sorbitan monooleate(polysorbate 80); and a block copolymer of polyethylene glycol andpolypropylene glycol having the formula [(HO(C₂H₄O)₆₄ (C₃H₆O)₃₇(C₂H₄O)₆₄H] (Poloxamer 237); wherein said polysorbate is present in anamount within the range of about 15% (wt/wt) to about 99% (wt/wt) ofsaid composition; and said Poloxamer 237 is present in an amount withinthe range of about 0.05% (wt/wt) to about 50% (wt/wt) of saidcomposition.